|Annals of Burns and Fire Disasters - vol. IX - n. 1 - March 1996
HONEY DRESSING FOR BURNS - AN APPRAISAL
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.
1 - Fresh burns in a 25 year-old-man.
2 - Burns completely healed within 8 day without residual scarring and with
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.
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|This paper was
received on 14 December 1994
Address correspondence to: Dr M. Subr Department of Surgery, Dr V.M. Medical Coll