Provision of the optimum moist healing environment

Honey dressings on wounds provide a moist healing environment: a feature sought in most modern wound dressings to obtain conditions necessary for optimum growth of the cells involved in the repair process. But, unlike other dressings, honey does this without the associated problems of encouraging microbial growth and maceration of surrounding skin that can result from the moist conditions. The antibacterial activity of honey prevents bacterial growth without any cytotoxic effects which could otherwise slow healing; and the osmotic action of its high sugar content will tend to draw fluid out from skin rather then let it soak in, even if honey gets diluted by large amounts of exudate. This means that there is no need to trim honey dressings to the shape of the wound bed or to use protective coverings on peri-wound skin, and there is no restriction on using occlusive secondary dressings. It has been suggested that the osmotic effect would dehydrate wound tissues but, in a paper on the use of sugar as a wound dressing, it has been pointed out that where there is a circulation of blood underneath to replace fluid lost from cells, the osmotic effect of sugar on the surface just creates an outflow of fluid (Chirife et al, 1982).

Also, unlike other dressings, honey dressings are easy to remove (Blomfield, 1973; Wadi et al, 1987; Farouk et al, 1988;Dunford et al, 2000a, b; Robson et al, 2000; Betts and Molan, 2001; Cooper et al, 2001; Alcaraz and Kelly, 2002; Richards, 2002; Stewart, 2002; Misirlioglu et al, 2003), causing no pain on changing dressings (Bulman, 1955; McInerney, 1990; Weheida et al, 1991; Subrahmanyam, 1993; Subrahmanyam, 1998; Dunford and Hanano, 2004). This is because the outflow of fluid from the wound bed created by the osmotic action of the honey forms a layer of diluted honey in contact with the wound bed. This fluid interface allows the dressings to be lifted off painlessly, preventing the tearing away of newly regenerated tissue which can happen when an adherent wound dressing is pulled off.

Back to top