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Honey has been an integral part of the medicinal culture in different parts of the world since ages. It is one of the earliest known dressings for wounds (ref. 1,2,3).
In an endeavor to find an ideal material for burn wound dressing at affordable price, we revisited this traditional remedy and found it to fulfill all the criteria to be rated on top of the list of all available dressing material.
Before TreatmentAfter Treatment |
The clinical observations recorded in other international studies are that infection is rapidly cleared, inflammation, swelling and pain is decreased, odour is decreased, desloughing of necrotic tissue is induced granulation and epithelialisation are hastened and healing occurs rapidly with minimum scarring. It has achieved healing of wounds not responding to conventional therapy with antibiotics and antiseptics (ref 4,5,6,7,8,9) including wounds with resistant bacteria (ref 10). On the basis of these observations it was thought that the time has now come to lift the blinds off this traditional remedy and let it earn proper recognition.
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Before TreatmentAfter TreatmentIn many of the reports effectiveness of honey as a dressing for burn/infected wounds is attributed largely to its anti bacterial properties, which are primarily due to H2 O2 formed in a slow release manner by the enzyme glucose oxidase present in honey. It also provides a supply of glucose for leucocytes essential for respiratory burst that produces H2 O211, the dominant component of the antibacterial activity of macrophages. The other contributory factors are high sugar concentration, acid pH of honey, creation of a physical barrier between wound and environmental contamination (ref 12), promotion of formation of healthy granulation tissue. It contain growth factors to enhance epithelialisation (ref 13,14,15). It reduces inflammation & edema, hence improves flow of blood in and lymph out of the area. All these factors are working at one time therefore healing occurs remarkably rapidly making plastic reconstruction unnecessary at times (ref 14,16). MATERIAL AND METHODS All patients of both sexes and all age groups having burn wounds reporting to us from June 1999 to December 2001 were included in this study. A routine baseline workup with blood and urine examination, Serum creatinine, Blood sugar was done at the time of admission. The patients who expired during treatment were excluded. Pts. were showered with plenty of plain water first and then wounds were washed thoroughly with jet stream of normal saline. Gauze pieces were soaked with commercially available tube packed honey and applied on wounds. A second layer of sterile cotton dressing pads were applied and secured with a 3rd layer of crepe bandage. The dressings were changed in this manner daily. In all patients having involvement of symmetric areas like both upper and/or lower limbs, right side was allocated to honey dressings and left side for silver suphadiazine to keep all the other variables like age, sex, mode and depth of burn at a constant. A continuous visual and photographic record was maintained at frequent intervals. Culture and sensitivity tests from wound surface were done regularly on weekly basis till the wound spontaneously healed or grafted. |
Results