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HISTORICAL USAGE OF HONEY
The ancient Egyptians, Assyrians, Chinese, Greeks, and Romans all used honey, alone and in combination with herbs, to treat wounds. Aristotle (circa 350 BC) wrote of honey being a salve for wounds and sore eyes, and Dioscorides (circa 50 AD) wrote of honey being ‘‘good for sunburn and spots on the face’’ and ‘for all rotten and hollow ulcers.’’ The usage of honey has continued into present-day folk medicine; for example, it is a traditional therapy for infected leg ulcers in Ghana. In recent times, it has been rediscovered by the medical profession, possibly because the ‘‘antibiotic era’’ is coming to an end as increasing numbers of bacterial strains develop resistance to antibiotics.
The ancient Egyptians, Assyrians, Chinese, Greeks, and Romans all used honey, alone and in combination with herbs, to treat wounds. Aristotle (circa 350 BC) wrote of honey being a salve for wounds and sore eyes, and Dioscorides (circa 50 AD) wrote of honey being ‘‘good for sunburn and spots on the face’’ and ‘for all rotten and hollow ulcers.’’ The usage of honey has continued into present-day folk medicine; for example, it is a traditional therapy for infected leg ulcers in Ghana. In recent times, it has been rediscovered by the medical profession, possibly because the ‘‘antibiotic era’’ is coming to an end as increasing numbers of bacterial strains develop resistance to antibiotics.
MODERN CLINICAL EVIDENCE
The clinical evidence in support of the effectiveness of honey in wound care has been comprehensively reviewed. This review summarizes the findings of 17 randomized controlled trials involving 1965 participants and 5 clinical trials of other forms involving 97 participants treated with honey. The trials found that honey was more effective than the control treatments, which were mostly conventional woundcare practices. Only in 1 trial, on burns, was the control treatment, early surgical tangential incision, found to be more effective than dressing the wounds with honey; this was only in respect of control of infection. The review also summarizes the findings of 16 trials on 533 wounds on experimental animals; again, honey was found to be more effective than the controls in assisting wound healing. In addition, a large amount of evidence is summarized in the form of case studies that have been reported. Ten publications have reported on multiple cases, totaling 276 cases. There are also 35 reports of single cases.
The clinical evidence in support of the effectiveness of honey in wound care has been comprehensively reviewed. This review summarizes the findings of 17 randomized controlled trials involving 1965 participants and 5 clinical trials of other forms involving 97 participants treated with honey. The trials found that honey was more effective than the control treatments, which were mostly conventional woundcare practices. Only in 1 trial, on burns, was the control treatment, early surgical tangential incision, found to be more effective than dressing the wounds with honey; this was only in respect of control of infection. The review also summarizes the findings of 16 trials on 533 wounds on experimental animals; again, honey was found to be more effective than the controls in assisting wound healing. In addition, a large amount of evidence is summarized in the form of case studies that have been reported. Ten publications have reported on multiple cases, totaling 276 cases. There are also 35 reports of single cases.
The authors believe this evidence is far greater than that for modern wound dressings. The promotional efforts for modern wound dressings, compared with the marketing of honey, may give clinicians the impression that modern dressings offer much more evidence than honey. In fact, the authors suggest that only poor-quality trials exist to support the modern wound dressings used today. Perhaps the most heavily marketed wound dressings are the nanocrystalline silver dressings. Yet, if the PubMed database is searched for clinical evidence to support their use, it is observed that only a small amount of significant evidence has been published to date. A conclusion reached in a recent systematic review of publications on the use of advanced dressings (hydrocolloids, polyurethane, alginate, dextranomer, polyhydroxyethyl methacrylate, amino acid copolymer, etc) in the treatment of pressure ulcers found that their generalized use in the treatment of pressure ulcers is not supported by quality research evidence.
At present, a general movement toward evidence-based medicine exists. Following this approach, decisions should be made based on the available evidence. If randomized controlled trials of the highest quality have not been conducted, then it is necessary to consider evidence of a lower quality. It is the authors’ opinion that marketing campaigns should not influence clinical decisions without good clinical evidence.
Source:
Using Honey to Heal Diabetic Foot Ulcers
P. C. Molan, BSc, PhD, and J. A. Betts, NP, RN, AdDipN, MN(Hons)
P. C. Molan, BSc, PhD, and J. A. Betts, NP, RN, AdDipN, MN(Hons)
Note:
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