Annals of Burns and Fire Disasters - vol. IX - n. 1 - March 1996


Subrahmanyam M.

Department of Surgery, Dr. V. M. Medical College, Solapur, Maharashtra, India

SUMMARY. In a prospective randomized study, honey was used as a dressing for partial-thickness burns (<40% TBSI period in 450 patients and the results were compared to those obtained in the same number of patients treated by c,,ven the same period. The wounds treated with honey healed earlier than those treated with conventional methods (8.8 da S Residual scars were noted in 28 patients (6.2%) in patients treated with honey and in 89 patients (19.7%) treatc methods.


The medicinal properties of honey have been known since ancient times. Ayurveda (Indian medicine) described honey as the nectar of life and recommended its use in various ailments. Ayurvedic stalwarts such as Charaka and Sushruta included honey in their dressing aids to purify sores and promote the healing of fistulous tracts.' The Edwin Smith papyrus of ancient Egypt (1500 B.C.) contained recommendations on wound management and mentioned the treatment of burns with honey. Russian and Chinese soldiers used honey as a healing agent for wounds in World War 1. Honey has been used in bums and ulcers to reduce infection and promote wound healing.

With a view to evaluating the clinical use of honey in burns, a prospective randomized study was carried out in order to compare honey dressing with conventional methods, and the results are reported.


A total of 900 patients with partial-thickness bums in less than 40% TBSA treated in the period July 1987December 1993 formed the material for this study. A detailed history was obtained regarding the mode of injury. The criteria for inclusion were: partial -thickness burns judged by appearance, presence of blisters of desquarnated skin, capillary return, and sensitivity. After initial treatment, the cases were divided at random into a study group treated with honey dressing and a control group treated with conventional dressing. The study was approved by the local committee and informed consent was obtained. The extent of injury in the groups ranged ftom 5 to 40%. The general management was the same for all patients.
In the study group (450 patients) the blisters and loose skin were excised. After washing of the wounds with normal saline, 15 to 30 ml (depending on burn extent) of pure, unprocessed, undiluted honey obtained from beehives was applied to the surface of the the burn. After honey was covered with sterile gauze , f Honey was applied on alternate days and t e C continued until the wounds healed. The h sterile on bacteriological examination.


In the treatment of burns, the prey! ention and treatment of infection are major aims. Variousl' methods, e.g. exposure of burns, closed methods using i gauze and bandages, vaseline gauze, antibiotic creams and the covering of wounds with polyurethane film, have been used with varying results, but none has comple,~ely eliminated infection. An easily available and cheap dressing material with the power of controlling infection still ~remains an enigma.
Honey is a mixture of sugars prepared by bees from the natural sugar solutions obtaineq from flowers. The wound-healing properties of honey have been well documented.` The chemical debriding action of honey and its absorption by the wounds cause a honey-impregnated gauze to remain moist and adhere very little to the wound surface. The beneficial effects of honey include the cleansing of wounds, absorption of oedema fluids, antimicrobial activity, promotion of granulation tissue, epithelialization and the improvement of nutrition

Fig. 1 - Fresh burns in a 25 year-old-man. Fig. 2 - Burns completely healed within 8 day without residual scarring and with minimal depigmentation.
Fig. 1 - Fresh burns in a 25 year-old-man. Fig. 2 - Burns completely healed within 8 day without residual scarring and with minimal depigmentation.

In this prospective study, honey-treated wounds were found to heal earlier than those treated with conventional methods. It was also noted that residual scars and depigmentation were reduced with the honey dressing. The exact composition of honey depends mainly on the plant source it is derived from. The antibacterial properties of honey are attributed to its low pH (3.6), its hygroscopic property and an inhibine factor which appears to be hydrogen peroxide, an end product of the enzymatic reaction of glucose oxidase (from the bee) with glucose in diluted honey."," Its dilution and floral origin decide the amount of hydrogen peroxide released per hour.
The hygroscopic property of hot dehydration of tissue fluids around tf decreasing tissue turgor, improving tiss and promoting wound healing. In this multifloral ori2in was used after confirrey may cause wound, thus ie oxygenation tudy, honey of ation of its ste rility. Although measurement of the iT ihibine count` and a check hether the honey passes through filter paper have been advised,` we did not find this necessary, because bacterial cultures before rid after treatment showed that honey inhibit the gisms. Honey was used from the begi of organing until the wounds healed without any adverse ef et on ranulation tissue and the actual wound repair was found in the case of sugar-treated u inspection department certified the ho study and it was therefore unlikely to h pesticides.

RESUME. Dans une étude prospective randomisée l'auteur a utilisé le miel comme médication pour les brûlures à «40% de la surface corporelle totale) pendant une période de six ans dans 450 patients et il a confronté les résultats même période dans le même nombre de patients traités avec des méthodes conventionnelles. Les lésions traitées avec le mechanism, as cers.1 The food ey used in the ve residues olomized control burn lesions togmentation.paisseur partielle ,%tenus pendant la àiel ont guéri plus rapidement que les lésions traitées avec les méthodes conventionnelles (8,8 jours contre 13,5 jours). Des cicatrices r~siduelles ont été observées chez 28 (6.2%) des patients traités avec le miel et chez 89 (19.7%) des patients traités avec les méthodes converitionelles.


  1. Grover S.K, Prasad C.S.: Use of Madhu in Ayurveda. Journal of NIMA, 10: 7-10, 1985.
  2. Effem S.S.E.: Clinical observations on the wound-healing properties of honey. Br. J. Surg., 75: 679-81, 1988.
  3. Philips C.E.: Honey for bums. Gleanings in Bee Culture, 61: 284,1933.
  4. Voigtlander N.: Honey for burns and scalds. The Bee World, 18: 12.128, 1937.
  5. Subrahmanyam M.: Topical application of honey in treatment of 13.burns. Br. J. Surg., 78:497-8,1991.
  6. Bregmaii A., Yamai J., Wiss J., Bell D., David M.P.: Acceleration of wound healing by topical application of honey. An animal model. 14.Am. J. Surg., 145: 374-6, 1983.
  7. Bulman M.V.: Honey as a surgical dressing. Middlesex Hosp. J., 55:188-9,1955
  8. Moncrief J.A.: Topical antibacterial therapy for burn wounds. Clin.Plast. Surg., 1: 563-76, 1974.
  9. Poulsen T.D., Freund K.G., Arendrup K., Nyhus P.. Pederson O.D.: Polyurethane film (OpSite) vs. impregnated gauze 0elonct) in the treatment of outpatient burns: a prospective randomized study. Burns, 17: 59-61, 1991.
  10. White J.A.: Composition of honey. In: "Honve survey" (Ed. Crane E.), pp, 175-206, He1975,
  11. White J.W., Subers M.M., Schwartz A.I.: The iblue, the antibacterial factor in honey, as hysystem and its origin in a honey glucose oxida Biophys. Acta, 73: 57-70, 1962.
  12. Postems T., van den Bogaard A., Nazen M.:ulcers and skin graft preservation. Lancet, 34 1:a comprehensiemann, London, ntification of inhirogen peroxidase system. Biochem. oney for wounds, 6-7, 1993.
  13. Phuapradit W., Sapola N.: Topical application oI honey in treatment of abdominal wound disruption. Aust. NZ. Obstet. Gynaecol., 32: 381-4, 1992.
  14. Seal D.V., Middleton K.: Healing of cavity wounds with sugar. Lancet, 338: 571-7, 1991.
This paper was received on 14 December 1994

Address correspondence to: Dr M. Subr Department of Surgery, Dr V.M. Medical Coll Maharashtra, India


Contact Us