Honey and Contemporary Wound Care: An Overview
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Index: Ostomy Wound Manage. 2007l53(11):49-54.
Honey provides a sugar-rich food source for bees. They harvest honey as nectar, a sugary fluid (approximately 80% water) produced by a variety of plants in order to attract insects and subsequently promote cross-pollination. The bees transport the nectar back to the hive where the nectar is “processed” and transformed into honey (80% sugar, 17% water). The honey then is stored and sealed in the comb using beeswax. During hive processing, most of the water is removed; the binding of the remaining water molecules and the addition of enzymes by the bees help ensure that microbial growth is not supported.1
The many different types of honey and the nuances of the finished product depend not only on the flower source, but also on a variety of factors including weather and climatic conditions. Not all honeys are the same. As flavor, consistency, and color of honey vary so do its therapeutic purposes. These variations in characteristics led Molan2 to the conclusion that honey should not be considered a generic term.
The therapeutic properties of honey are variable and depend on the type of honey used. Manuka (the Maori name for the New Zealand tea tree/bush Leptospermum scoparium) or Leptospermum is honey derived from the tea tree; the former is the more widely used term. In a review of the literature, Moore3 showed that Manuka honey has “very special healing properties” and described it as “the best natural antibiotic in the world.”
Medical grade Manuka honey is prepared purely for medical use and controlled by a rigorous set of systems and standards.4 These exacting standards apply to the leptospermum honey distributed in US (Medihoney™, Derma Sciences, Princeton, NJ). This product is a blend of L. scoparium (Manuka) and L. polygalifolium know as Jelly Bush.
The purpose of this review is to accentuate the wide-ranging therapeutic advantages that honey can offer using examples from the literature.
Honey as a therapeutic agent has a history that dates back thousands of years; this fact assists in underpinning its therapeutic credentials. Namias6 noted that honey is mentioned in relation to healing in the Bible, the Koran, and the Torah. In addition, the Edwin Smith Papyrus (17th century BC), Hippocrates, and Democritus in ancient Greece, Galen in ancient Rome, and Avicenna in medieval times all have recorded the medical properties of honey.7,8
Until the first part of the 20th century, honey dressings were part of everyday wound care practice. With the advent of antibiotics in the 1930s and 1940s, views changed and honey was consigned to items of historical interest. Misuse of antibiotics, the emergence of resistant bacteria, and increasing interest in therapeutic honey have provided an opportunity for honey to be re-established as a broad-spectrum, antibacterial agent that is non-toxic to human tissue.