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Papanikolaou GE, Gousios G, Cremers NAJ, Peters LJF. Treating Infected Non-Healing Venous Leg Ulcers with Medical-Grade Honey: A Prospective Case Series. Antibiotics (Basel) 2024; 13:614. [PMID: 39061296 PMCID: PMC11274243 DOI: 10.3390/antibiotics13070614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
Venous leg ulcers (VLUs) are hard-to-heal wounds and are prone to microbial colonization. Innovative and improved therapies are thus required to resolve local infection and enhance the wound healing process. The objective of this study was to evaluate the effectiveness of medical-grade honey (MGH) for the treatment of clinically infected and non-healing VLUs. This prospective case series included nine patients with an average age of 83.4 years (range: 75-91 years) with a total of eleven VLUs, previously ineffectively treated with various products. Major risk factors for the appearance of VLUs were chronic venous insufficiency, advanced age, multiple comorbidities (particularly cardiovascular diseases), and impaired mobility. All wounds presented with local signs of infection. Upon presentation, treatment was commenced with a range of MGH-based products (L-Mesitran®). Clinical signs of infection were eliminated by MGH after 2.2 weeks on average (range: 1-4 weeks), and wounds were completely healed after 7 weeks on average (range: 3-18 weeks). No further complications or recurrences were observed. MGH has a broad-spectrum antimicrobial activity and promotes rapid healing, thus improving patients' quality of life. Moreover, MGH-based products are safe, easy to use, cost-effective, and can effectively treat VLUs alone or in combination with standard-of-care therapies.
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Affiliation(s)
| | | | - Niels A. J. Cremers
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, P. Debyelaan 25, 6229HX Maastricht, The Netherlands
- Triticum Exploitatie BV, Sleperweg 44, 6222NK Maastricht, The Netherlands;
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Holubová A, Chlupáčová L, Krocová J, Cetlová L, Peters LJF, Cremers NAJ, Pokorná A. The Use of Medical Grade Honey on Infected Chronic Diabetic Foot Ulcers-A Prospective Case-Control Study. Antibiotics (Basel) 2023; 12:1364. [PMID: 37760661 PMCID: PMC10525154 DOI: 10.3390/antibiotics12091364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/16/2023] [Accepted: 08/23/2023] [Indexed: 09/29/2023] Open
Abstract
Non-healing wounds are usually colonised and contaminated by different types of bacteria. An alternative to antibiotic treatment in patients with infected wounds with local signs of inflammation may be medical grade honey (MGH). MGH has antioxidant, antimicrobial, anti-inflammatory, and immunomodulatory features. This study aims to evaluate the effect of MGH therapy on infected non-healing wounds, especially for diabetic foot syndrome. Prospective, observational case series (n = 5) of patients with wounds of diabetic foot syndrome are presented. There were five males with an average age of 61.6 years. All wounds were treated with MGH, and the healing trajectory was rigorously and objectively monitored. In all cases, there was a gradual disappearance of odour, pain, and exudation. Moreover, the wound areas significantly reduced within 40 days and there was a decrease in glycated haemoglobin and glycaemia values. All these outcomes resulted in improved quality of life of the patients. Despite bacterial colonisation, antibiotic treatment was not necessary. All wounds were completely healed. MGH has antimicrobial, anti-inflammatory, and antioxidant effects in diabetic foot syndrome wounds, does not increase glycated haemoglobin or glycaemia levels, and thus constitutes an effective alternative to the use of antibiotics in the treatment of locally infected wounds.
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Affiliation(s)
- Adéla Holubová
- Faculty of Health and Social Sciences, University of South Bohemia, 370 11 České Budějovice, Czech Republic;
- DiaPodi Care, spol. s r.o., 392 01 Soběslav, Czech Republic;
| | | | - Jitka Krocová
- Department of Nursing and Midwifery, Faculty of Health Studies, University of West Bohemia, 301 00 Pilsen, Czech Republic;
| | - Lada Cetlová
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
| | | | - Niels A. J. Cremers
- Triticum Exploitatie BV, Sleperweg 44, 6222 NK Maastricht, The Netherlands;
- Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, The Netherlands
| | - Andrea Pokorná
- Department of Health Sciences, College of Polytechnics Jihlava, 586 01 Jihlava, Czech Republic; (L.C.); (A.P.)
- Department of Health Sciences, Faculty of Medicine, Masaryk University, 625 00 Brno, Czech Republic
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Naik PP, Chrysostomou D, Cinteza M, Pokorná A, Cremers NA. When time does not heal all wounds-the use of medical grade honey in wound healing: a case series. J Wound Care 2022; 31:548-558. [PMID: 35797263 DOI: 10.12968/jowc.2022.31.7.548] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants, and can severely impact the quality of life (QoL) of patients. Due to the paucity of effective treatments and increased resistance to antibiotics, new and improved therapies are required to resolve infections and to simultaneously enhance the healing trajectory. Medical grade honey (MGH) may be a novel and effective treatment approach. METHODS In this case series, we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate). In all cases, the wounds had persisted for a long period, and previous treatments had been ineffective. Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria, both of which contributed to non-healing. All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy. RESULTS Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH. All wounds healed relatively quickly, considering the severity of the wounds and general health of the patients. CONCLUSION In this study, MGH was a useful alternative or complementary therapy to antibiotics and expedited the healing of hard-to-heal wounds.
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Affiliation(s)
- Piyu Parth Naik
- Saudi German Hospitals and Clinics, Department of Dermatology, Hessa Street 331 West, Al Barsha3, Exit 36 Sheikh Zayed Road, Opposite of American School, Dubai, United Arab Emirates
| | - Daniela Chrysostomou
- Wound Clinic Health@45, Linksfield Road 45, Dowerglen, Johannesburg, South Africa
| | - Mirela Cinteza
- SC Podotim Medica SRL, RO41116267, J/35/2118/2019, Moșnița Veche, Jud Timiș, Romania
| | - Andrea Pokorná
- Department of Health Sciences, Faculty of Medicine, Masaryk University, Czech Republic.,College of Polytechnics Jihlava, Jihlava, Czech Republic
| | - Niels Aj Cremers
- Triticum Exploitatie BV, Sleperweg 44, 6222NK Maastricht, the Netherlands.,Department of Gynecology and Obstetrics, Maastricht University Medical Centre, 6202 AZ Maastricht, the Netherlands
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Tomczyk M, Bocian A, Sidor E, Miłek M, Zaguła G, Dżugan M. The Use of HPTLC and SDS-PAGE Methods for Coniferous Honeydew Honey Fingerprinting Compiled with Mineral Content and Antioxidant Activity. Molecules 2022; 27:molecules27030720. [PMID: 35163985 PMCID: PMC8838849 DOI: 10.3390/molecules27030720] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 11/23/2022] Open
Abstract
Fir honeydew honey is a uniquely beneficial product which is often subjected to adulteration; however, pollen analysis is not useful to verify this honey type. Fourteen samples of EU protected designation of origin fir honeydew honey gathered directly from apiaries were studied. Standards of legal requirements and additional parameters, i.e., specific optical rotation, mineral content, and antioxidant activity, were tested. Five nectar honeys of different varieties were used as a comparative material. HPTLC and SDS-PAGE methods were used to fingerprint the honey types. All honeys tested fulfilled the quality requirements in terms of water content, pH, total acidity, conductivity, HMF, and diastase number. They were defined as dark amber on the Pfund scale and exhibited positive specific rotation (+2.5 to 25). Honeydew honey surpassed the tested nectar honeys in terms of mineral content and antioxidant activity as well as total polyphenolic content, except for buckwheat honey. The sugar and polyphenolic profile obtained by HPTLC allowed to distinguish honeydew from nectar honeys. The same was achieved by SDS-PAGE protein profiling. Both techniques seem to be cheap and quick tools for precisely distinguishing honeydew honey.
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Affiliation(s)
- Monika Tomczyk
- Department of Chemistry and Food Toxicology, Institute of Food Technology and Nutrition, College of Natural Sciences, University of Rzeszow, 35–601 Rzeszow, Poland; (A.B.); (E.S.); (M.M.); (M.D.)
- Correspondence: ; Tel.: +48-17872-17-21
| | - Aleksandra Bocian
- Department of Chemistry and Food Toxicology, Institute of Food Technology and Nutrition, College of Natural Sciences, University of Rzeszow, 35–601 Rzeszow, Poland; (A.B.); (E.S.); (M.M.); (M.D.)
- Department of Biotechnology and Bioinformatics, Faculty of Chemistry, Rzeszow University of Technology, 35–959 Rzeszow, Poland
| | - Ewelina Sidor
- Department of Chemistry and Food Toxicology, Institute of Food Technology and Nutrition, College of Natural Sciences, University of Rzeszow, 35–601 Rzeszow, Poland; (A.B.); (E.S.); (M.M.); (M.D.)
- Doctoral School, University of Rzeszow, Poland, 35–959 Rzeszow, Poland
| | - Michał Miłek
- Department of Chemistry and Food Toxicology, Institute of Food Technology and Nutrition, College of Natural Sciences, University of Rzeszow, 35–601 Rzeszow, Poland; (A.B.); (E.S.); (M.M.); (M.D.)
| | - Grzegorz Zaguła
- Department of Bioenergetics, Food Analysis and Microbiology, Institute of Food Technology and Nutrition, College of Natural Sciences, University of Rzeszow, 35–601 Rzeszow, Poland;
| | - Małgorzata Dżugan
- Department of Chemistry and Food Toxicology, Institute of Food Technology and Nutrition, College of Natural Sciences, University of Rzeszow, 35–601 Rzeszow, Poland; (A.B.); (E.S.); (M.M.); (M.D.)
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Seraglio SKT, Schulz M, Gonzaga LV, Fett R, Costa ACO. Current status of the gastrointestinal digestion effects on honey: A comprehensive review. Food Chem 2021; 357:129807. [PMID: 33915465 DOI: 10.1016/j.foodchem.2021.129807] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 03/15/2021] [Accepted: 03/27/2021] [Indexed: 12/30/2022]
Abstract
In the past five years, more than 8000 scientific reports have been published on honey composition and its potential bioactivity as a source of pro-health components. However, the potential effectiveness of nutrients and other compounds in the human body is greatly influenced by the individual digestion conditions. Consequently, changes in the structure of honey components and their interactions with other constituents are expected and they may affect the bioaccessibility, the bioavailability, and further physiological functions of honey nutrients and bioactives. In this context, in addition to present key physiological characteristics for each step of the human digestion and their simulation aspects, this review also summarizes and discusses available data regarding the effect of the digestion (in vitro and in vivo) on honey compounds. Additionally, we consider the influence of the digestion on biological activities described for the compounds in the honey.
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Affiliation(s)
| | - Mayara Schulz
- Department of Food Science and Technology, Federal University of Santa Catarina, 88034-001 Florianópolis, SC, Brazil
| | - Luciano Valdemiro Gonzaga
- Department of Food Science and Technology, Federal University of Santa Catarina, 88034-001 Florianópolis, SC, Brazil
| | - Roseane Fett
- Department of Food Science and Technology, Federal University of Santa Catarina, 88034-001 Florianópolis, SC, Brazil
| | - Ana Carolina Oliveira Costa
- Department of Food Science and Technology, Federal University of Santa Catarina, 88034-001 Florianópolis, SC, Brazil.
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Silva B, Biluca FC, Gonzaga LV, Fett R, Dalmarco EM, Caon T, Costa ACO. In vitro anti-inflammatory properties of honey flavonoids: A review. Food Res Int 2021; 141:110086. [PMID: 33641965 DOI: 10.1016/j.foodres.2020.110086] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 12/22/2020] [Accepted: 12/25/2020] [Indexed: 12/15/2022]
Abstract
Honey is a natural ready-to-eat product rich in flavonoids, which is known by the wound healing properties due to both antibacterial and antioxidant activity. Flavonoids mitigate inflammatory processes, and thus it could currently support studies of anti-inflammatory potential of honeys. In this review, in vitro anti-inflammatory properties of flavonoids found in honey were prioritized. Mechanistic information of specific isolated flavonoids as modulators of inflammatory processes are summarized aiming to stimulate studies regarding the action of honey in inflammatory events. Lastly, a structure-activity relationship (SAR) of flavonoids was also included. Flavonoids found in honey have demonstrated antioxidant properties and ability to inhibit pro-inflammatory enzymes such as COX, LOX, iNOS, and pro-inflammatory mediators, including nitric oxide, cytokines and chemokines. Transcriptional factors such as NF-κB are also modulated by flavonoids, controlling the expression of several inflammatory mediators. SAR studies demonstrate the effect of flavonoids in the prevention of inflammatory cascades. Despite the promising reports of in vitro anti-inflammatory activity, well-designed clinical trials need yet to be performed to confirm the benefits of honeys from different botanical sources in diseases that include episodes of inflammation.
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Affiliation(s)
- Bibiana Silva
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, SC, Brazil.
| | - Fabíola Carina Biluca
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Luciano Valdemiro Gonzaga
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | - Roseane Fett
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianópolis, SC, Brazil
| | | | - Thiago Caon
- Department of Pharmaceutical Sciences, Federal University of Santa Catarina, Florianópolis, SC, Brazil
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Ren SY, Liu YS, Zhu GJ, Liu M, Shi SH, Ren XD, Hao YG, Gao RD. Strategies and challenges in the treatment of chronic venous leg ulcers. World J Clin Cases 2020; 8:5070-5085. [PMID: 33269244 DOI: 10.12998/wjcc.v8.i21.5070.pmid:] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/06/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023] Open
Abstract
Evaluating patients with chronic venous leg ulcers (CVLUs) is essential to find the underlying etiology. The basic tenets in managing CVLUs are to remove the etiological causes, to address systemic and metabolic conditions, to examine the ulcers and artery pulses, and to control wound infection with debridement and eliminating excessive pressure on the wound. The first-line treatments of CVLUs remain wound care, debridement, bed rest with leg elevation, and compression. Evidence to support the efficacy of silver-based dressings in healing CVLUs is unavailable. Hydrogen peroxide is harmful to the growth of granulation tissue in the wound. Surgery options include a high ligation with or without stripping or ablation of the GSVs depending on venous reflux or insufficiency. Yet, not all CVLUs are candidates for surgical treatment because of comorbidities. When standard care of wound for 4 wk failed to heal CVLUs effectively, use of advanced wound care should be considered based on the available evidence. Negative pressure wound therapy facilitates granulation tissue development, thereby helping closure of CVLUs. Autologous split-thickness skin grafting is still the gold standard approach to close huge CVLUs. Hair punch graft appears to have a better result than traditional hairless punch graft for CVLUs. Application of adipose tissue or placenta-derived mesenchymal stem cells is a promising therapy for wound healing. Autologous platelet-rich plasma provides an alternative strategy for surgery for safe and natural healing of the ulcer. The confirmative efficacy of current advanced ulcer therapies needs more robust evidence.
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Affiliation(s)
- Shi-Yan Ren
- Department of General Surgery and Vascular Surgery, Aviation General Hospital, China Medical University, Beijing 100012, China.
| | - Yong-Sheng Liu
- Department of Dermatology, Aviation General Hospital, Beijing 100012, China
| | - Guo-Jian Zhu
- Department of General Surgery, Taian Communications Hospital, Taian 271000, Shandong Province, China
| | - Meng Liu
- Department of Surgery, Tianjin Hexi Hospital, Tianjin 300202, Tianjin, China
| | - Shao-Hui Shi
- Department of Orthopaedic Surgery, Aviation General Hospital, China Medical University, Beijing 100012, China
| | - Xiao-Dong Ren
- Department of Surgery, Wanquanqu Zhongyi Hospital, Zhangjiakou 076250, Hebei Province, China
| | - Ya-Guang Hao
- Department of Medical Administrative, Aviation General Hospital, China Medical University, Beijing 100012, China
| | - Rong-Ding Gao
- Department of General Surgery, Aviation General Hospital, China Medical University, Beijing 100012, China
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8
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Ren SY, Liu YS, Zhu GJ, Liu M, Shi SH, Ren XD, Hao YG, Gao RD. Strategies and challenges in the treatment of chronic venous leg ulcers. World J Clin Cases 2020; 8:5070-5085. [PMID: 33269244 PMCID: PMC7674718 DOI: 10.12998/wjcc.v8.i21.5070] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 08/06/2020] [Accepted: 09/28/2020] [Indexed: 02/05/2023] Open
Abstract
Evaluating patients with chronic venous leg ulcers (CVLUs) is essential to find the underlying etiology. The basic tenets in managing CVLUs are to remove the etiological causes, to address systemic and metabolic conditions, to examine the ulcers and artery pulses, and to control wound infection with debridement and eliminating excessive pressure on the wound. The first-line treatments of CVLUs remain wound care, debridement, bed rest with leg elevation, and compression. Evidence to support the efficacy of silver-based dressings in healing CVLUs is unavailable. Hydrogen peroxide is harmful to the growth of granulation tissue in the wound. Surgery options include a high ligation with or without stripping or ablation of the GSVs depending on venous reflux or insufficiency. Yet, not all CVLUs are candidates for surgical treatment because of comorbidities. When standard care of wound for 4 wk failed to heal CVLUs effectively, use of advanced wound care should be considered based on the available evidence. Negative pressure wound therapy facilitates granulation tissue development, thereby helping closure of CVLUs. Autologous split-thickness skin grafting is still the gold standard approach to close huge CVLUs. Hair punch graft appears to have a better result than traditional hairless punch graft for CVLUs. Application of adipose tissue or placenta-derived mesenchymal stem cells is a promising therapy for wound healing. Autologous platelet-rich plasma provides an alternative strategy for surgery for safe and natural healing of the ulcer. The confirmative efficacy of current advanced ulcer therapies needs more robust evidence.
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Affiliation(s)
- Shi-Yan Ren
- Department of General Surgery and Vascular Surgery, Aviation General Hospital, China Medical University, Beijing 100012, China
| | - Yong-Sheng Liu
- Department of Dermatology, Aviation General Hospital, Beijing 100012, China
| | - Guo-Jian Zhu
- Department of General Surgery, Taian Communications Hospital, Taian 271000, Shandong Province, China
| | - Meng Liu
- Department of Surgery, Tianjin Hexi Hospital, Tianjin 300202, Tianjin, China
| | - Shao-Hui Shi
- Department of Orthopaedic Surgery, Aviation General Hospital, China Medical University, Beijing 100012, China
| | - Xiao-Dong Ren
- Department of Surgery, Wanquanqu Zhongyi Hospital, Zhangjiakou 076250, Hebei Province, China
| | - Ya-Guang Hao
- Department of Medical Administrative, Aviation General Hospital, China Medical University, Beijing 100012, China
| | - Rong-Ding Gao
- Department of General Surgery, Aviation General Hospital, China Medical University, Beijing 100012, China
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Kuś PM. Honey as Source of Nitrogen Compounds: Aromatic Amino Acids, Free Nucleosides and Their Derivatives. Molecules 2020; 25:molecules25040847. [PMID: 32075114 PMCID: PMC7070497 DOI: 10.3390/molecules25040847] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Revised: 02/11/2020] [Accepted: 02/12/2020] [Indexed: 12/18/2022] Open
Abstract
The content of selected major nitrogen compounds including nucleosides and their derivatives was evaluated in 75 samples of seven varieties of honey (heather, buckwheat, black locust, goldenrod, canola, fir, linden) by targeted ultra-high performance liquid chromatography-diode array detector - high-resolution quadrupole time-of-flight mass spectrometry (UHPLC-DAD-QqTOF-MS) and determined by UHPLC-DAD. The honey samples contained nucleosides, nucleobases and their derivatives (adenine: 8.9 to 18.4 mg/kg, xanthine: 1.2 to 3.3 mg/kg, uridine: 17.5 to 51.2 mg/kg, guanosine: 2.0 to 4.1 mg/kg; mean amounts), aromatic amino acids (tyrosine: 7.8 to 263.9 mg/kg, phenylalanine: 9.5 to 64.1 mg/kg; mean amounts). The amounts of compounds significantly differed between some honey types. For example, canola honey contained a much lower amount of uridine (17.5 ± 3.9 mg/kg) than black locust where it was most abundant (51.2 ± 7.8 mg/kg). The presence of free nucleosides and nucleobases in different honey varieties is reported first time and supports previous findings on medicinal activities of honey reported in the literature as well as traditional therapy and may contribute for their explanation. This applies, e.g., to the topical application of honey in herpes infections, as well as its beneficial activity on cognitive functions as nootropic and neuroprotective, in neuralgia and is also important for the understanding of nutritional values of honey.
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Affiliation(s)
- Piotr M Kuś
- Department of Pharmacognosy and Herbal Medicines, Faculty of Pharmacy, Wroclaw Medical University, ul. Borowska 211a, 50-556 Wrocław, Poland
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The Effect of Gargling Cold Normal Saline in Comparison to Normal Saline Mixed with Honey on Postoperative Pain Relief in Tonsillectomy or Adenotonsillectomy: A Randomized Clinical Trial. IRANIAN RED CRESCENT MEDICAL JOURNAL 2020. [DOI: 10.5812/ircmj.94971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Abstract
Reduction of chronic wound pain has the potential to improve patients' quality of life, expedite the healing process and, ultimately, relieve pressure on community services. Despite this, education on pain assessment in the management of chronic wounds is lacking. This literature review seeks to provide evidence-based recommendations to reduce chronic wound pain and inform the practice of community nurses. The results of a thematic analysis indicate that a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain, and nitroglycerin ointment is especially effective. The review also highlights the need for an individualised approach to the assessment and treatment of pain in patients with chronic wounds.
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Affiliation(s)
| | - Anne Baileff
- The Faculty of Health Sciences, University of Southampton
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Martinotti S, Bucekova M, Majtan J, Ranzato E. Honey: An Effective Regenerative Medicine Product in Wound Management. Curr Med Chem 2019; 26:5230-5240. [DOI: 10.2174/0929867325666180510141824] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 04/09/2018] [Accepted: 04/10/2018] [Indexed: 12/12/2022]
Abstract
:Honey has successfully been used in the treatment of a broad spectrum of injuries including burns and non-healing wounds. It acts as an antibacterial and anti-biofilm agent with anti/pro-inflammatory properties. However, besides these traditional properties, recent evidence suggests that honey is also an immunomodulator in wound healing and contains several bee and plant-derived components that may speed up wound healing and tissue regeneration process. Identifying their exact mechanism of action allows better understanding of honey healing properties and promotes its wider translation into clinical practice.:This review will discuss the physiological basis for the use of honey in wound management, its current clinical uses, as well as the potential role of honey bioactive compounds in dermal regenerative medicine and tissue re-modeling.
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Affiliation(s)
- Simona Martinotti
- DiSIT-Dipartimento di Scienze e Innovazione Tecnologica, University of Piemonte Orientale, Viale Teresa Michel 11, Alessandria, 15121, Italy
| | - Marcela Bucekova
- Laboratory of Apidology and Apitherapy, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska cesta 21, 845 51, Bratislava, Slovakia
| | - Juraj Majtan
- Laboratory of Apidology and Apitherapy, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska cesta 21, 845 51, Bratislava, Slovakia
| | - Elia Ranzato
- DiSIT-Dipartimento di Scienze e Innovazione Tecnologica, University of Piemonte Orientale, Piazza Sant'Eusebio 5, Vercelli, 13100, Italy
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Dámaso Fernández-Ginés F, Cortiñas-Sáenz M, Mateo-Carrasco H, de Aranda ANG, Navarro-Muñoz E, Rodríguez-Carmona R, Fernández-Sánchez C, Sierra-García F, Morales-Molina JA. Efficacy and safety of topical sevoflurane in the treatment of chronic skin ulcers. Am J Health Syst Pharm 2019; 74:e176-e182. [PMID: 28438822 DOI: 10.2146/ajhp151008] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Results of efficacy and safety assessments of topical sevoflurane use in patients with long-term treatment-refractory vascular ulcers are reported. METHODS Patients were randomly assigned to receive sevoflurane instillations (1 mL per cm2 of ulcer area 1-4 times daily) plus standard wound care (ulcer cleaning, debridement, and dressing changes) or standard care only. Topical sevoflurane was initiated during hospitalization, with self- or nurse-administered instillations continued after discharge. Study participants were evaluated at least once weekly for 1 month and then every 2 weeks for up to 90 days. The primary efficacy measures were debridement-related and overall pain (assessed using a 10-point visual analog scale), daily opioid use, and ulcer size; secondary measures were patient and clinician impressions of improvement and ulcer-related admissions during treatment. The primary safety endpoint was intolerable sevoflurane-related adverse effects. RESULTS Compared with the group receiving standard care alone (n = 5), the sevoflurane group (n = 10) had significant (p = 0.001) reductions in mean ± S.D. scores for debridement-related pain on day 1 of treatment and at subsequent time points; the sevoflurane group also had significant reductions in overall pain, daily opioid use, and ulcer size. Outcomes in terms of patient- and clinician-rated improvement and emergency admissions also favored the sevoflurane group. Mild localized reddening in the area surrounding ulcers occurred in 4 sevoflurane-treated patients. CONCLUSION Direct application of sevoflurane onto vascular ulcers resulted in an intense and long-lasting analgesia and was associated with a progressive reduction of ulcer size.
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Affiliation(s)
| | - Manuel Cortiñas-Sáenz
- Anesthesiology and Pain Management Department, Torrecárdenas Hospital, Almería, Spain
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Seraglio SKT, Silva B, Bergamo G, Brugnerotto P, Gonzaga LV, Fett R, Costa ACO. An overview of physicochemical characteristics and health-promoting properties of honeydew honey. Food Res Int 2019; 119:44-66. [PMID: 30884675 DOI: 10.1016/j.foodres.2019.01.028] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2018] [Revised: 12/22/2018] [Accepted: 01/13/2019] [Indexed: 01/08/2023]
Abstract
Honeydew honey has differentiated chemical and physicochemical characteristics besides potential functional properties such as antimicrobial, anti-inflammatory and antioxidant. In this sense, the interest and consumption of this honey as a functional product by the food industry and consumers have increased. Honeydew honeys usually present dark color, a lower content of monosaccharides and higher values of pH, acidity, electric conductivity, proteins, minerals, phenolic compounds, and oligosaccharides compared to blossom honeys, which contribute to its outstanding biological activities. Consequently, contaminations and adulterations of this honey can occur and compromise the quality, safety and authenticity of honeydew honey. Thus, detailed knowledge of the composition and properties of honeydew honeys is of great importance, especially considering that honeydew honeys are still few studied and therefore underestimated. Therefore, in this review, the physicochemical characteristics, chemical and bioactive composition, functional and health-promoting properties of honeydew honey as well as contamination, adulteration and authenticity of this honey are summarized.
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Affiliation(s)
| | - Bibiana Silva
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Greici Bergamo
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Patricia Brugnerotto
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Luciano Valdemiro Gonzaga
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Roseane Fett
- Department of Food Science and Technology, Federal University of Santa Catarina, Florianopolis, SC, Brazil
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Kuś PM, Jerković I. New Sample Preparation Method for Honey Volatiles Fingerprinting Based on Dehydration Homogeneous Liquid⁻Liquid Extraction (DHLLE). Molecules 2018; 23:E1769. [PMID: 30029465 PMCID: PMC6099691 DOI: 10.3390/molecules23071769] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/13/2018] [Accepted: 07/13/2018] [Indexed: 11/24/2022] Open
Abstract
Qualitative chemical fingerprinting of the honey volatiles by gas chromatography and mass spectrometry (GC-MS) has been an efficient authentication tool that allowed for the classification of the honey botanical origin (strongly related to its medicinal and market value). However, the usage of current sample preparation methods is limited by selectivity of the volatiles extraction from the honey matrix and requires significant solvent volume. Therefore, a new sample preparation method based on dehydrating homogeneous liquid⁻liquid extraction (DHLLE) involving reduced solvent usage was developed for screening volatiles and semi-volatiles from the honey. The effective extraction was achieved by implementing a miscible liquid extraction system (aqueous honey solution/isopropanol) followed by separation through dehydration with MgSO₄ and purification by a solvent polarity change and washing. The method was evaluated by estimating accuracy and precision. The DHLLE method showed satisfactory recoveries (75.2 to 93.5%) for typical honey volatiles: linalool, borneol, terpinen-4-ol, α-terpineol, p-anisaldehyde, eugenol, and vanillin. It also showed superior repeatability with percent relative standard deviation (RSD%) 0.8⁻8.9%. For benzyl alcohol, methyl syringate, and caffeine, the recoveries were 54.3 to 63.9% and 67.3 to 77.7% at lower and higher spiking levels, respectively. Applied to unifloral apple honey, the DHLLE method allowed for the identification of 40 compounds including terpenes, hydrocarbons, phenylpropanoids, and other benzene derivatives, which makes it suitable for fingerprinting and chemical marker screening. The obtained results were comparable or better than those obtained with ultrasonic extraction with dichloromethane.
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Affiliation(s)
- Piotr M Kuś
- Department of Pharmacognosy, Wrocław Medical University, ul. Borowska 211a, 50-556 Wrocław, Poland.
| | - Igor Jerković
- Department of Organic Chemistry, Faculty of Chemistry and Technology, University of Split, Ruđera Boškovića 35, 21000 Split, Croatia.
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Bucekova M, Buriova M, Pekarik L, Majtan V, Majtan J. Phytochemicals-mediated production of hydrogen peroxide is crucial for high antibacterial activity of honeydew honey. Sci Rep 2018; 8:9061. [PMID: 29899462 PMCID: PMC5998132 DOI: 10.1038/s41598-018-27449-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/04/2018] [Indexed: 12/21/2022] Open
Abstract
Honeydew honey is increasingly valued due to its pronounced antibacterial potential; however, the underlying mechanism and compounds responsible for the strong antibacterial activity of honeydew honey are still unknown. The aim of this study was to investigate the inhibition of bacterial growth of 23 honeydew honey samples. Activity of bee-derived glucose oxidase (GOX) enzyme, the content of defensin-1 (Def-1) and hydrogen peroxide (H2O2), and total polyphenol content were determined in the 23 honey samples. Our results demonstrated that antibacterial activity of honeydew honey was equivalent to medical-grade manuka and kanuka honey and was abolished by catalase. Although H2O2 is an important factor in the inhibition of bacterial growth, polyphenolic compounds and their interaction with H2O2 are the key factors responsible for high antibacterial activity of honeydew honey. In addition, our results indicated that the antibacterial activity of honeydew honey is not dependent on GOX-mediated production of H2O2 or the presence of Def-1.
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Affiliation(s)
- Marcela Bucekova
- Laboratory of Apidology and Apitherapy, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska cesta 21, 845 51, Bratislava, Slovakia
| | - Monika Buriova
- Laboratory of Apidology and Apitherapy, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska cesta 21, 845 51, Bratislava, Slovakia
| | - Ladislav Pekarik
- Plant Science and Biodiversity Center, Slovak Academy of Sciences, Dubravska cesta 9, 845 23, Bratislava, Slovakia
| | - Viktor Majtan
- Department of Microbiology, Faculty of Medicine, Slovak Medical University, Limbova 12, 833 03, Bratislava, Slovakia
| | - Juraj Majtan
- Laboratory of Apidology and Apitherapy, Institute of Molecular Biology, Slovak Academy of Sciences, Dubravska cesta 21, 845 51, Bratislava, Slovakia.
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Fernández-Ginés FD, Cortiñas-Sáenz M, Navajas-Gómez de Aranda A, Navas-Martinez MDC, Morales-Molina JA, Sierra-García F, Mateo-Carrasco H. Palliative analgesia with topical sevoflurane in cancer-related skin ulcers: a case report. Eur J Hosp Pharm 2018; 26:229-232. [PMID: 31338175 DOI: 10.1136/ejhpharm-2017-001421] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 12/19/2017] [Indexed: 11/04/2022] Open
Abstract
A Caucasian 39-year-old male patient with a poorly-differentiated infiltrating epidermoid penile carcinoma with urethral invasion was diagnosed. The patient received concomitant adjuvant chemotherapy with radiotherapy in the palliative setting, which produced painful ulceration of tumour lesions at loco-regional level (Numerical Rate Scale, NRS=9). The patient consented for treatment with direct topical sevoflurane instillations, at initial doses of 1 mL/cm2 of ulcerated area, as per unit protocol. The local use of undiluted sevoflurane achieved a marked reduction of the pain score in both nociceptive and irruptive pains (average NRS=3 immediately post-application). This improvement was corroborated by a decline in total morphine needs, any adverse events associated with major opiates. PGI-I and CGI-I scales were used before and after treatment with topical sevoflurane to assess patient and clinician perceptions of improvement in the quality of life. The pharmacy of our hospital had the responsibility to elaborate pre-loaded syringes with sevoflurane so that the patient was instilled simply and comfortably.
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18
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Kuś PM, Jerković I, Marijanović Z, Tuberoso CIG. Screening of Polish Fir Honeydew Honey Using GC/MS, HPLC-DAD, and Physical-Chemical Parameters: Benzene Derivatives and Terpenes as Chemical Markers. Chem Biodivers 2017; 14. [PMID: 28657207 DOI: 10.1002/cbdv.201700179] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Accepted: 06/23/2017] [Indexed: 01/23/2023]
Abstract
GC/MS of headspace solid phase micro extraction (HS-SPME) and solvent extractives along with targeted HPLC-DAD of Polish fir (Abies alba Mill.) honeydew honey (FHH), were used to determine the chemical profiles and potential markers of botanical origin. Additionally, typical physical-chemical parameters were also assigned. The values determined for FHH were: conductivity (1.2 mS/cm), water content (16.7 g/100 g), pH (4.5), and CIE chromaticity coordinates (L* = 48.4, a* = 20.6, b* = 69.7, C* = 72.9, and h° = 73.5). FHH contained moderate-high total phenolic content (533.2 mg GAE/kg) and antioxidant activity (1.1 mmol TEAC/kg) and (3.2 mmol Fe2+ /kg) in DPPH and FRAP assays. The chemical profiles were dominated by source plant-originated benzene derivatives: 3,4-dihydroxybenzoic acid (up to 8.7 mg/kg, HPLC/honey solution), methyl syringate (up to 14.5%, GC/solvent extracts) or benzaldehyde (up to 43.7%, GC/headspace). Other markers were terpenes including norisoprenoid (4-hydroxy-3,5,6-trimethyl-4-(3-oxobut-1-enyl)cyclohex-2-en-1-one, up to 20.3%, GC/solvent extracts) and monoterpenes, mainly linalool derivatives (up to 49%, GC/headspace) as well as borneol (up to 5.9%, GC/headspace). The application of various techniques allowed comprehensive characterisation of FHH. 4-Hydroxy-3,5,6-trimethyl-4-(3-oxobut-1-enyl)cyclohex-2-en-1-one, coniferyl alcohol, borneol, and benzaldehyde were first time proposed for FHH screening. Protocatechuic acid may be a potential marker of FFH regardless of the geographical origin.
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Affiliation(s)
- Piotr M Kuś
- Department of Pharmacognosy, Wrocław Medical University, ul. Borowska 211a, 50-556, Wrocław, Poland
| | - Igor Jerković
- Department of Organic Chemistry, Faculty of Chemistry and Technology, University of Split, Ruđera Boškovića 35, 21000, Split, Croatia
| | - Zvonimir Marijanović
- Department of Food Technology, Marko Marulić Polytechnic in Knin, Petra Krešimira IV 30, 22300, Knin, Croatia
| | - Carlo I G Tuberoso
- Department of Life and Environmental Sciences, University of Cagliari, via Ospedale 72, 09124, Cagliari, Italy
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Saxena S, Tripathi J, Chatterjee S, Gautam S. Natural Predominance of Abscisic Acid in Pongammia pinnata ("Karanj") Honey Contributed to its Strong Antimutagenicity. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2017; 65:4624-4633. [PMID: 28535345 DOI: 10.1021/acs.jafc.7b01529] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Various samples of raw (unprocessed) floral honey collected from different geographical locations of India were assayed for its antimutagenicity against ethyl methanesulfonate in E. coli MG1655 cells through rifampicin resistance assay. A monofloral honey ("Pongammia pinnata", local name "Karanj") displayed maximum antimutagenicity (78.0 ± 1.7; P ≤ 0.05). Solid phase extraction (using Amberlite XAD-2 resin) followed by HPLC resulted into different peaks displaying varying antimutagenicity. Peak at retention time (Rt) 27.9 min (henceforth called P28) displayed maximum antimutagenicity and was further characterized to be abscisic acid (ABA) using ESI-MS and NMR. Its antimutagenicity was reconfirmed through human lymphoblast cell line (TK6) mutation assay using thymidine kinase (tk+/-) cell line. Although ABA from this honey displayed strong antimutagenicity, it lacked any in vitro antioxidant capacity indicating noninvolvement of any radical scavenging in the observed antimutagenicity.
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Affiliation(s)
- Sudhanshu Saxena
- Food Technology Division, Bhabha Atomic Research Centre , Mumbai 400094, India
| | - Jyoti Tripathi
- Food Technology Division, Bhabha Atomic Research Centre , Mumbai 400094, India
| | | | - Satyendra Gautam
- Food Technology Division, Bhabha Atomic Research Centre , Mumbai 400094, India
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Horniackova M, Bucekova M, Valachova I, Majtan J. Effect of gamma radiation on the antibacterial and antibiofilm activity of honeydew honey. Eur Food Res Technol 2016. [DOI: 10.1007/s00217-016-2725-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Poovelikunnel T, Gethin G, Humphreys H. Mupirocin resistance: clinical implications and potential alternatives for the eradication of MRSA. J Antimicrob Chemother 2015; 70:2681-92. [DOI: 10.1093/jac/dkv169] [Citation(s) in RCA: 117] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N, Cochrane Wounds Group. Honey as a topical treatment for wounds. Cochrane Database Syst Rev 2015; 2015:CD005083. [PMID: 25742878 PMCID: PMC9719456 DOI: 10.1002/14651858.cd005083.pub4] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Honey is a viscous, supersaturated sugar solution derived from nectar gathered and modified by the honeybee, Apis mellifera. Honey has been used since ancient times as a remedy in wound care. Evidence from animal studies and some trials has suggested that honey may accelerate wound healing. OBJECTIVES The objective of this review was to assess the effects of honey compared with alternative wound dressings and topical treatments on the of healing of acute (e.g. burns, lacerations) and/or chronic (e.g. venous ulcers) wounds. SEARCH METHODS For this update of the review we searched the Cochrane Wounds Group Specialised Register (searched 15 October 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 9); Ovid MEDLINE (1946 to October Week 1 2014); Ovid MEDLINE (In-Process & Other Non-Indexed Citations 13 October 2014); Ovid EMBASE (1974 to 13 October 2014); and EBSCO CINAHL (1982 to 15 October 2014). SELECTION CRITERIA Randomised and quasi-randomised trials that evaluated honey as a treatment for any sort of acute or chronic wound were sought. There was no restriction in terms of source, date of publication or language. Wound healing was the primary endpoint. DATA COLLECTION AND ANALYSIS Data from eligible trials were extracted and summarised by one review author, using a data extraction sheet, and independently verified by a second review author. All data have been subsequently checked by two more authors. MAIN RESULTS We identified 26 eligible trials (total of 3011 participants). Three trials evaluated the effects of honey in minor acute wounds, 11 trials evaluated honey in burns, 10 trials recruited people with different chronic wounds including two in people with venous leg ulcers, two trials in people with diabetic foot ulcers and single trials in infected post-operative wounds, pressure injuries, cutaneous Leishmaniasis and Fournier's gangrene. Two trials recruited a mixed population of people with acute and chronic wounds. The quality of the evidence varied between different comparisons and outcomes. We mainly downgraded the quality of evidence for risk of bias, imprecision and, in a few cases, inconsistency.There is high quality evidence (2 trials, n=992) that honey dressings heal partial thickness burns more quickly than conventional dressings (WMD -4.68 days, 95%CI -5.09 to -4.28) but it is unclear if there is a difference in rates of adverse events (very low quality evidence) or infection (low quality evidence).There is very low quality evidence (4 trials, n=332) that burns treated with honey heal more quickly than those treated with silver sulfadiazine (SSD) (WMD -5.12 days, 95%CI -9.51 to -0.73) and high quality evidence from 6 trials (n=462) that there is no difference in overall risk of healing within 6 weeks for honey compared with SSD (RR 1.00, 95% CI 0.98 to 1.02) but a reduction in the overall risk of adverse events with honey relative to SSD. There is low quality evidence (1 trial, n=50) that early excision and grafting heals partial and full thickness burns more quickly than honey followed by grafting as necessary (WMD 13.6 days, 95%CI 9.82 to 17.38).There is low quality evidence (2 trials, different comparators, n=140) that honey heals a mixed population of acute and chronic wounds more quickly than SSD or sugar dressings.Honey healed infected post-operative wounds more quickly than antiseptic washes followed by gauze and was associated with fewer adverse events (1 trial, n=50, moderate quality evidence, RR of healing 1.69, 95%CI 1.10 to 2.61); healed pressure ulcers more quickly than saline soaks (1 trial, n= 40, very low quality evidence, RR 1.41, 95%CI 1.05 to 1.90), and healed Fournier's gangrene more quickly than Eusol soaks (1 trial, n=30, very low quality evidence, WMD -8.00 days, 95%CI -6.08 to -9.92 days).The effects of honey relative to comparators are unclear for: venous leg ulcers (2 trials, n= 476, low quality evidence); minor acute wounds (3 trials, n=213, very low quality evidence); diabetic foot ulcers (2 trials, n=93, low quality evidence); Leishmaniasis (1 trial, n=100, low quality evidence); mixed chronic wounds (2 trials, n=150, low quality evidence). AUTHORS' CONCLUSIONS It is difficult to draw overall conclusions regarding the effects of honey as a topical treatment for wounds due to the heterogeneous nature of the patient populations and comparators studied and the mostly low quality of the evidence. The quality of the evidence was mainly downgraded for risk of bias and imprecision. Honey appears to heal partial thickness burns more quickly than conventional treatment (which included polyurethane film, paraffin gauze, soframycin-impregnated gauze, sterile linen and leaving the burns exposed) and infected post-operative wounds more quickly than antiseptics and gauze. Beyond these comparisons any evidence for differences in the effects of honey and comparators is of low or very low quality and does not form a robust basis for decision making.
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Affiliation(s)
- Andrew B Jull
- University of AucklandSchool of NursingPrivate Bag 92019AucklandNew Zealand
| | - Nicky Cullum
- University of ManchesterSchool of Nursing, Midwifery and Social WorkJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Jo C Dumville
- University of ManchesterSchool of Nursing, Midwifery and Social WorkJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Maggie J Westby
- University of ManchesterSchool of Nursing, Midwifery and Social WorkJean McFarlane BuildingOxford RoadManchesterUKM13 9PL
| | - Sohan Deshpande
- Kleijnen Systematic ReviewsUnit 6, Escrick Business ParkRiccall Road, EscrickYorkUKYO19 6FD
| | - Natalie Walker
- University of AucklandNational Institute for Health InnovationPrivate Bag 92019AucklandNew Zealand
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Tin SS, Wiwanitkit V. Honey for non-healing leg ulcers. J Tissue Viability 2014; 23:137. [DOI: 10.1016/j.jtv.2014.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/10/2014] [Accepted: 10/22/2014] [Indexed: 11/26/2022]
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