RE: What is the evidence for Manuka Honey?

Georgie Hollis — Fri, 04 Sep 2020 14:38:02 GMT

Hi there, i've seen that one person disagrees with the comments i made here and it is perfectly ok to disagree. Please do say what you disagree with and i'll be happy to clarify or revise. :-)

RE: Manuka Honey - Evidence

Georgie Hollis — Wed, 05 Aug 2020 09:52:23 GMT

You've asked a good question and a very valid one that needs to be asked about every single thing that is used on wounds, or on anything for that matter.

There are some considerations here that we will cover in the Honey Month on the VWL (sorry for blatant plug, but £25 for 3 month membership and i'm going to cover EVERYTHING about honey during August - from what honey is, to why its used, to the difference between plant species used to make it and shop bought versus medical grade. You'll have 3 months to watch everything so hoping this is insanely good value as we want people to use us)

So i'll break this down a bit.

1. What do we mean by Evidence? Honey (and dressings in general) are medical devices not medicines so they don't need to have a pharmaceutical licence to be sold. WHICH means that.... they don't need the robust evidence that you would expect from a drug, such as an antibiotic. eg. RCT that states product A inhibits Bacteria X better than product B, or no product at all C (or control) ....

2. The problem with dressings in general: You won't find definitive evidence that says honey will make wounds heal quicker. Because that is not what it is doing. Products do not heal wounds, they just create or assist you in creating an environment that does not inhibit the healing process. So think of it as a tool (a device) that helps you achieve your aims. Those are to assist optimal healing.

3. So what does honey actually do? This is the real crux of it. We have to understand WHY you are using honey and in what part of the process of healing its' properties will be beneficial. Honey (any honey) is Osmotic (ie. pulls exudate into the wound), it is Antimicrobial (due to low pH, its components (plant derived as well as bee derived) and has a range of enzymatic actions. It therefore helps to debride - due to the osmotic action and helps to decontaminate. That is it....

4. So why not use honey on everything? Honey is overused these days as people use it for everything after they have had a positive outcome with a case. It is only necessary as a tool to aid debridement where surgical debridement is not possible, or where further wound decontamination is required. All of this will be during the inflammatory phase of healing not during proliferation (granulating/epithelialising wounds) as the properties are of no benefit. In fact they will be detrimental as granulation tissue would prefer not to be in a wet and acidic environment.

5. Finally - coming back to Evidence. So we have to recognise that getting a statement that honey makes wounds heal faster isn't really realistic as the variables are too many and too complex to prove. We can only get evidence for the actual effects and the result of those effects. ie. Antimicrobial inhibition of certain honeys. Eg. Heather honey versus Manuka Honey, then layer on top of these more studies that compare different honeys in terms of osmotic effect - eg. relative osmotic and antimicrobial effect of diluted UMF20 Manuka v fully saturated UMF20 Manuka (you would have to be sure it was the same batch etc. etc.) ... Hopefully this starts to illustrate how you are looking at what the product actually does rather than the culminated effect of management that leads to the healed wound. We just can't say that honey made the wound heal faster - it just helps us manage the aspect of the physiology that will inhibit healing if we do nothing at all.

I hope that makes sense! But we'll definitely be covering all of this in the webinars at the Vet Wound Library this month.

RE: Manuka Honey - Evidence

simon johnson — Tue, 04 Aug 2020 21:11:07 GMT

So I remember about 4 years ago, I was handrearing a kitten (5days old) who had its arm removed by its Mother at birth. A couple mini procedures later it had staples and had broke down. I believe I had applied honey BID for many many weeks and at the time our Veterinary Surgeon swore by it - I think under the belief that it aids in granulation, and maintaining a perfect environment for wound healing. This I just applied topically but did not cover, so was very sticky. This vet then seemed to not use manuka honey very often as years went on ( I don't know why)

In my current practice they love manuka honey and am currently seeing a cat in every 3 days for bandage changes including applying a manuka honey and renofoam primary dressing to some horrendous looking injuries of unknown origin on the back legs. They are healing well (its a naughty cat) But just sparked my curiosity, would the wounds be healing as great and as fast with or without honey?

RE: Manuka Honey - Evidence

Georgie Hollis — Tue, 04 Aug 2020 21:00:11 GMT

Would love to hear the opinions you've heard - can you share any of the detail?