How Effective Is Honey In Treating Resistant Wounds?

Can the ancient remedy of honey make an impact in treating wounds that are resistant to traditional antibiotics? Two articles, published recently in Ostomy Wound Management and in the Journal of Applied Microbiology, suggest honey may show some promise in wound healing. The Journal of Applied Microbiology study involved 18 strains of MRSA and seven strains of vancomycin-sensitive enterococci (VSE), which were isolated from infected wounds. Researchers established their sensitivity to two natural honeys of median levels of antibacterial activity and compared that with an artificial honey solution. The MIC values against manuka honey (with non-peroxide activity of 18% phenol) and pasture honey (with hydrogen peroxide activity of 13.7% phenol) were under 10 percent (v/v), according to the study. Researchers found that the concentrations of artificial honey had to be at least three times higher in order to achieve equivalent inhibition in vitro. The study’s in vitro tests demonstrated that two natural honeys were significantly more effective than an artificial honey solution in inhibiting MRSA and VSE. This finding runs counter to previous research that indicated that the sugar content of honey was solely responsible for its antibacterial effect. The authors of the study, Rose A. Cooper, Peter C. Molan and Keith G. Harding, concluded the inhibition of bacteria by honey is not exclusively due to osmolarity. For the gram-positive cocci tested, antibiotic-sensitive and –resistant strains showed similar sensitivity to honey. “The findings of this study, together with two previous studies, show honey offers promise as an effective wound antiseptic with broad spectrum antimicrobial activity,” the authors note in the Journal of Applied Microbiology study. A Closer Look At Studies That Reveal Faster Healing Dr. Molan, BSc(Hons), PhD, says the use of honey in wound healing may be coming back into vogue given the rise of antibiotic-resistant bacteria. In his recent Ostomy Wound Management (OWM) article, “Re-Introducing Honey In The Management Of Wounds and Ulcers—Theory And Practice,” Dr. Molan summarizes three prospective, randomized, controlled clinical trials. In the trials, researchers found honey helped heal superficial burns faster than polyurethane film or silver sulfadiazine ointment. One of the studies comparing honey-impregnated gauze with polyurethane film found that the mean time to healing with the first group was 4.5 days less than the polyurethane film group and “significantly fewer honey-dressed wounds became infected.” Studies also revealed a difference between honey-impregnated gauze and silver-sulfadiazine impregnated gauze. One study found that 87 percent of the honey-treated wounds healed in 15 days as opposed to just 10 percent of the silver sulfadiazine treated wounds. According to the OWM article, a second trial revealed that 100 percent of honey-treated wounds healed within 21 days whereas 84 percent of wounds treated with the silver sulfadiazine healed within the same time period. Assessing Other Potential Benefits of Honey Honey also has a few benefits over antibiotics and other topical agents. Drs. Cooper, Molan and Harding note that unlike antibiotics, honey doesn’t require any lab evaluation of susceptibility prior to treatment. They also point out that honey does not adversely affect tissue as other topical antimicrobials may do. They also emphasize that any modality that is inexpensive, non-toxic and has potential impact against antibiotic-resistant wounds warrants further research studies. Editor’s Note: For more information, check out Dr. Molan’s article in the November 2002 issue of Ostomy Wound Management (www.o-wm.com). Survey Provides Insight On Culturing Practices How often do you obtain a culture for a wound? When are cultures indicated? In an attempt to answer some of these questions, a survey was sent out to members of the Association for the Advancement Of Wound Care. The responses were recently published in the November/December 2002 issue of WOUNDS, a Compendium of Clinical Research and Practice. Approximately 80 percent of the respondents were registered nurses, physical therapists and physicians. The respondents had an average of 11 years experience in wound care and spent 64 percent of their time on direct wound care activities. Nearly 90 percent of the respondents culture wounds. For their thoughts on culturin, see the pie charts above. Editor’s Note: For more information, check out the article, “Diagnosis of Wound Infections: Current Culturing Practices of U.S. Wound Care Professionals,” in the November/December 2002 issue of WOUNDS (www.woundsresearch.com). In Brief Perhaps you’ve heard about the potential benefits of the Promogran matrix wound dressing, but you were curious about reimbursement levels. Recently, the dressing was assigned to the collagen category by the Statistical Analysis Durable Medical Equipment Regional Carrier, according to Johnson and Johnson Wound Management. You can use HCPCS codes A6021 and A6022 for Part-B Medicare reimbursement. Johnson and Johnson says the fee schedule ranges up to about $21 per application. Editor’s Note: For more information, see www.promogran.com and check out the Wound Care Q&A column on page 16. Hungry for HIPAA information? Well, DB Consultants has recently unveiled an upgrade to its AS/PC for Windows practice management software. According to the company, this upgrade will include enhancements that will help facilitate HIPAA compliance. It also offers a state-by-state breakdown of where the company stands on testing the new 4010 electronic format. For more info, check out www.dbconsultants.com