Barrier function

The high viscosity of honey provides a physical barrier to infection of wounds from external contamination, the effectiveness of which is increased by the antibacterial activity of the honey (as long as the honey used is selected to have good antibacterial activity). This feature is particularly useful where it is preferable to avoid occluding highly exudative wounds, such as burn wounds, and thus encourage growth of bacteria, particularly Pseudomonas spp, in the moist conditions created. Prophylactic use of honey dressings has been found to solve a problem of skin grafts frequently becoming infected with Pseudomonas spp (Robson, 2000). This raises the suggestion of using honey dressings routinely on surgical wounds to protect at-risk patients from acquiring nosocomial infection with MRSA — the demonstrated sensitivity of MRSA to honey and the reports of honey dressings healing wounds already infected with MRSA (Dunford et al, 2000a; Natarajan et al, 2001) indicate that it is likely to be effective as a prophylactic treatment. It is also likely to be effective as a prophylactic treatment for the other major route of nosocomial infection with MRSA, ie. sites where medical devices penetrate the skin, as indicated by the favourable results reported from a trial conducted on central vein catheter exit sites (Mutjaba Quadri, 1999).

Above: Illustration of concentration gradients set up by diffusion into underlying tissue of antibacterial activity of honey from high-activity and low-activity honey on the surface of the skin. ‘MIC’ shows the position on the gradients of the minimum inhibitory concentration of the antibacterial activity (ie. the minimum concentration that will stop bacterial growth). Thus, the functional components of a high activity honey will diffuse deeper into the tissues and have a greater range of antibacterial activity.

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