Honey dressings and autolytic debridement: a case series5th April 2013
Evans J, Mahoney K (2013) Efficacy of medical-grade honey as an autolytic debridement agent. Wounds UK 9(1): 30–36
A case series was carried out by the All Wales Tissue Viability Nurses Forum on medical-grade Manuka honey used for autolytic debridement in patients with a chronic wound that was at least 40% necrotic or sloughy. Products used in the series were Advancis Medical’s Activon Tube, Activon Tulle and Algivon, all used as a primary dressing. Data was collected at three consecutive dressing changes.
Of the 22 people recruited, 77% had pressure ulcers. Other wounds included surgical wounds and leg ulcers. Fifteen of the 22 had more than 40% necrotic tissue at the beginning of the study and 87% of these reduced to lower than 40% by the end of the three dressing changes. Two of the wounds with necrosis did not achieve any noticeable reduction in the amount of necrosis by the end of the study period, compared with 67% achieving complete debridement of the necrotic tissue.
Eight of the wounds were more than 40% sloughy at the start of the study. Complete debridement was achieved in 25% of the wounds and 90% were less than 40% slough after the three dressing applications.
The average time to achieve 100% debridement of either type of devitalized tissue was 31.7 days (range 6–109 days).
Other results noted were
- Granulation — more than half of the wounds were at least 61% granulation tissue at the end of the study as the honey encourages tissue growth.
- Complete wound healing was achieved in half of the participants.
- Malodour — was reduced in all patients who had malodour and was eliminated in 81%. This is due to a reduction of bacterial load and glucose in the honey being metabolised rather than amino acids.
- Pain — 71% of the patients had reduced pain levels at the end of the study, which challenges the idea that the use of honey on wounds may cause pain
- Exudate levels were reduced in 76% of the participants.
The authors conclude that honey dressings can be effective debridement agents and they also carry other benefits.