Does manuka honey help wounds heal, including after anorectal surgery?

Name: Does manuka honey help wounds heal, including after anorectal surgery?
Published: 2026-10-05

In patients with open or surgical wounds, including anorectal wounds such as those after hemorrhoidectomy, anal fistula surgery, or pilonidal sinus excision, does topical application of manuka honey compared with standard wound care improve wound healing time, infection rate, or complete healing at follow-up?

Compiled 2026-10-05 · checked 2026-10-05 · next 2026-11-05 · automated review, how it works

Bottom line

No study has tested manuka honey specifically on anorectal surgery wounds like hemorrhoidectomy or fistula surgery, and the one closest trial — on pilonidal sinus wounds — found no real benefit.

Of 78 related studies, only a pilonidal sinus wound trial and a pilonidal scoping review relate to anorectal surgery at all, and that trial found healing took about the same time with or without honey. Several other studies, in different wound types, found manuka honey could slow healing or damage tissue rather than help it, including one case where a wound worsened during treatment and a case report of a serious infection concern after topical honey use. Overall certainty is very low because almost all the evidence is indirect, testing other wounds, animals, or lab models.

How certain

Very low

The 78 human studies found measure a related question rather than this one, so they can only be read indirectly.

What it shows

Signal of harm

6 studies reported harm or tissue damage, including laboratory evidence.

studies found: 142studies found
randomised trials: 24randomised trials
people studied: 9,859people studied
reviews of trials: 18reviews of trials
years covered: 2015–2026years covered

Read this first

A case report describes an infant who developed sudden-onset paralysis, suspected to be wound botulism, days after topical medical-grade honey was used on a surgical wound; the diagnosis was not fully confirmed, but it raises a safety concern for open or deep wounds.
In one case report, a complex wound got worse during five weeks of manuka honey treatment and only started improving after switching to a different dressing.
Testing on human burn tissue outside the body found that a manuka honey product (Medihoney) completely stopped new skin cells from growing back and multiplying, and had a weaker antibacterial effect than a different honey blend (L-Mesitran Soft); this study did not report how it compared with silver-based treatments on skin regrowth.
A study in people needing dead tissue removed from wounds found honey took much longer than another plant-based dressing to clear dead tissue and infection.
Three separate animal studies found honey-treated wounds healed more slowly, with weaker tissue repair, than wounds treated without honey.

What the research shows

Time to complete wound healing after anorectal surgery (days)
The only trial in this exact setting (pilonidal sinus wounds) found average healing took about 61 days with honey versus 78 days without it, but this difference was not statistically significant.[1]
No improvement shown
Proportion of wounds fully healed at a defined follow-up
No identified trial reported what percentage of hemorrhoidectomy, fistula, or pilonidal wounds were completely healed at a set follow-up point like 4 or 8 weeks.
Not studied
Wound infection rate after anorectal surgery
No trial in anorectal surgical wounds reported infection rates with manuka honey dressings.
Not studied
Pain score during dressing changes (anorectal surgery)
Pain during dressing changes has been measured for honey at other surgical sites, such as the mouth, but not in anorectal surgery wounds.
Not studied
Wound size reduction over time (anorectal surgery)
No anorectal surgery trial tracked wound size shrinkage over time with manuka honey.
Not studied
Adverse reactions or tissue damage from honey dressings
Across other wound types, not anorectal surgery, six studies found honey slowed wound closure, damaged skin cells, or coincided with a serious infection concern — a human wound study, a case report where a wound worsened during treatment, a suspected case of wound botulism in an infant, and three animal studies showing impaired healing.[1,2,3,4,5,6]
Possible harm

Important limitations

Of the studies reviewed, only two looked at a related anorectal-area procedure - pilonidal cyst or sinus surgery wounds - and none specifically studied hemorrhoidectomy or anal fistula surgery wounds.[1,2]
Most studies that found a benefit for honey were done in completely different wounds, such as diabetic foot ulcers, burns, dental extraction sockets, and caesarean section incisions, which cannot be assumed to behave like anal or perianal wounds.[1,2,3]
Several of the harm signals come from animal models or tissue tested outside the body, not from patients, so how much they apply to human anorectal wounds is unclear.[1,2,3,4]
The one directly relevant trial, in pilonidal wounds, was small and from a single center, so it may simply have been too small to detect a true difference either way.[1]

Why people try it

It's marketed as 'natural' and 'medical-grade,' which can feel safer or gentler than manufactured treatments.
Manuka honey has a reputation for killing bacteria, so people hope it will prevent infection in a wound that's hard to keep clean, like one after anorectal surgery.
Online stories and product packaging often describe quick healing, which can feel more convincing than reading a study.
People want to avoid antibiotics or harsher chemical dressings.
Some clinicians suggest it as a seemingly low-risk option when standard dressings haven't worked.

What the studies found

Found a benefit85 · 60%
Found no clear effect10 · 7%
Mixed or unclear41 · 29%
Found possible harm6 · 4%

What kind of studies

Case series34 · 24%
Laboratory study29 · 20%
Randomised trial24 · 17%
Animal study19 · 13%
Narrative review15 · 11%
Meta-analysis10 · 7%
Systematic review8 · 6%
Registered trial, no results posted1 · 1%
Retrospective1 · 1%
Prospective cohort1 · 1%

The studies that decided it

Nnadozie et al. 2023
Wound bed preparation using nonsurgical methods: A prospective comparative study of honey versus unripe papaya (Carica papaya)
Papaya cleared wounds faster than honey.Prospective cohortLow qualityRelated question
64 people2023
honey took much longer than papaya to clear eschar and infection
Who was studied
patients with wounds needing eschar/slough removal before healing
What they received
honey dressing
Compared with
unripe papaya dressing
Main outcome
time for dead tissue (eschar) to separate and for infection to clear
Quality
small study that wasn't clearly randomized and compared two active treatments rather than honey versus no treatment
Limitations
not stated as randomized, no blinding described, compares honey to papaya rather than placebo or standard care, not anorectal surgery population
Taken word for word from the abstract
- n Sixty-four patients were assigned into two equal groups
- population The extension phase in which the wound is characterized by the presence of sloughs and eschar and microbial invasion could be managed nonsurgically.
- intervention each dressed, respectively, with unripe papaya or honey
- comparator each dressed, respectively, with unripe papaya or honey
- primaryOutcome All selected patients were monitored for eschar separation and bacterial clearance time.
- result Unripe papaya dressing had a mean eschar separation time of 5.53 ± 2.20 days and bacterial clearance time of 6.81 ± 3.64 days compared to the honey group which had an eschar separation time of 30.09 ± 27.90 days and bacterial clearance time of 15.33 ± 13.62 days.
Ann Afr Med · PMID 38358154 · Read it on PubMed ↗
Boekema et al. 2024
Comparing the antibacterial and healing properties of medical-grade honey and silver-based wound care products in burns
Manuka honey stopped wound skin regrowth.Laboratory studyVery low qualityRelated question
size not given2024
Medihoney (Manuka) killed bacteria but caused complete lack of re-epithelialization and keratinocyte proliferation, performing worse than silver-based products and the honey blend L-Mesitran
Who was studied
human burn wound tissue infected with bacteria (ex vivo model), plus some clinical burn cases
What they received
medical-grade honey (Medihoney/Manuka and L-Mesitran Soft)
Compared with
silver-based wound products (Flammazine, silver nitrate)
Main outcome
bacterial reduction and wound healing (re-epithelialization and keratinocyte proliferation)
Quality
This was a lab-based ex vivo tissue model with no reported patient numbers or controlled clinical trial design, so it can't reliably predict real-world healing outcomes.
Limitations
Ex vivo burn wound model, not a clinical trial; no participant numbers reported; clinical cases mentioned only as illustrative examples, not systematically studied.
Taken word for word from the abstract
- population ex vivo human burn wound model
- intervention Medihoney (Manuka)
- comparator Flammazine (silver sulphadiazine), and silver nitrate (AgNO3)
- primaryOutcome Bacterial survival and wound healing parameters, including re-epithelialization and keratinocyte proliferation were assessed.
- result Medihoney treatment resulted in a complete lack of re-epithelialization and keratinocyte proliferation
- result L-Mesitran Soft exhibited a significantly stronger antimicrobial effect compared to Medihoney.
Burns · PMID 37940425 · Read it on PubMed ↗
Abet et al. 2023
The value of honey dressings in pilonidal cyst healing: a prospective randomized single-center trial
No significant difference in healing time.Randomised trialModerate qualityRelated question
100 people2023
average healing time was 61 days with honey versus 78 days without, a difference that was not statistically significant
Who was studied
patients with a wound after pilonidal cyst removal that hadn't healed and needed packing 6 weeks after surgery
What they received
alginate dressing plus honey
Compared with
alginate dressing alone
Main outcome
time for the wound to heal
Quality
it was a randomized trial but found no statistically significant difference and was conducted at a single center over many years
Limitations
did not reach significance in its primary endpoint; single center; long recruitment period from 2016-2022
Taken word for word from the abstract
- n Fifty patients were included in each arm.
- population patients with a persistent non healed wound which required packing 6 weeks after pilonidal cyst excision
- intervention the same design plus honey
- comparator simple alginate wick dressings
- primaryOutcome The mean healing time was 61 (± 44) days in the wick + honey group compared to 78 (± 55) days in the simple alginate wick group (p = 0.094).
- result The mean healing time was 61 (± 44) days in the wick + honey group compared to 78 (± 55) days in the simple alginate wick group (p = 0.094).
Tech Coloproctol · PMID 36598614 · Read it on PubMed ↗
Mohd Tamrin 2020
The dilemma of diagnosing wound botulism in an infant: A rare case of paralysis with topical application of honey
Found harmCase seriesVery low qualityRelated question
1 people2020
This infant developed a sudden progressive flaccid paralysis a few days after the application of topical medical grade honey for wound care. Even though suspicion of wound botulism is high, confirmation of the diagnosis, detection of neurotoxin, and isolating the organism remains a challenge.
Who was studied
an infant with an infected umbilical stump, which required a surgical wound debridement
What they received
application of topical medical grade honey for wound care
Main outcome
developed a sudden progressive flaccid paralysis a few days after the application of topical medical grade honey for wound care
Quality
this is a single case report, which cannot show whether honey usually helps or harms wounds, only that this one possible complication occurred.
Limitations
single case, diagnosis of wound botulism not confirmed by toxin detection or organism isolation, no comparison group
Taken word for word from the abstract
- population We present a case of an infant with an infected umbilical stump, which required a surgical wound debridement.
- intervention application of topical medical grade honey for wound care
- primaryOutcome This infant developed a sudden progressive flaccid paralysis a few days after the application of topical medical grade honey for wound care.
- result This infant developed a sudden progressive flaccid paralysis a few days after the application of topical medical grade honey for wound care. Even though suspicion of wound botulism is high, confirmation of the diagnosis, detection of neurotoxin, and isolating the organism remains a challenge.
- n We present a case of an infant
Int J Infect Dis · PMID 32220630 · Read it on PubMed ↗
Sawazaki et al. 2018
Efficacy of Honeydew Honey and Blossom Honey on Full-thickness Wound Healing in Mice
Slower healing than standard dressings.Animal studyLow qualityRelated question
140 people14 days
all honey groups showed reepithelialization rates of less than 40%, numerous neutrophils, weak wound contraction, and impaired collagen deposition after day 11, and were less effective at promoting full-thickness wound healing than the controls
Who was studied
mice with full-thickness skin wounds
What they received
honey treatments (honeydew honey, Acacia honey, Manuka honey, Japanese Pharmacopoeia honey) applied to wounds
Compared with
gauze dressing or hydrocolloid dressing (no honey)
Main outcome
wound healing over 14 days, including wound area, reepithelialization, and collagen deposition
Quality
This is a small mouse experiment, not a human study, so it cannot directly tell us how honey affects human surgical wounds.
Limitations
Animal (mouse) model of full-thickness skin wounds, not human anorectal surgical wounds; abstract does not describe blinding or statistical details.
Taken word for word from the abstract
- n A total of 140 mice were divided into 2 control groups, which received either a hydrocolloid dressing (HCD; n = 22) or gauze (n = 22), and 4 experimental groups: honeydew honey (n = 23), Acacia honey (n = 23), Manuka honey (n = 22), and Japanese Pharmacopoeia honey (n = 28).
- population Two circular full-thickness wounds were made and measured for 14 days.
- intervention Each wound in the experimental groups was treated with 0.1 mL of honey and covered with gauze.
- comparator 2 control groups, which received either a hydrocolloid dressing (HCD; n = 22) or gauze (n = 22)
- primaryOutcome Two circular full-thickness wounds were made and measured for 14 days.
- result the honey groups exhibited reepithelialization rates of < 40%, numerous neutrophils, weak wound contraction, and impaired collagen deposition in wounds after day 11
- result all of the honeys examined were less effective at promoting full-thickness wound healing than the controls
Wounds · PMID 29718813 · Read it on PubMed ↗
Mukai et al. 2017
Effectiveness of Changing the Application of Japanese Honey to a Hydrocolloid Dressing in Between the Inflammatory and Proliferative Phases on Cutaneous Wound Healing in Male Mice
Slower healing than dressing alone.Animal studyLow qualityRelated question
size not given14 days
honey-treated wounds healed faster at first but then re-expanded and showed delayed reepithelialization, collagen deposition, and contraction compared with dressing alone
Who was studied
male mice with full-thickness skin wounds
What they received
Japanese honey (acacia, buckwheat flour, or Chinese milk vetch) applied for 3 days then covered with a hydrocolloid dressing
Compared with
hydrocolloid dressing alone
Main outcome
wound healing measured by wound area, reepithelialization, collagen deposition, and wound contraction
Quality
this is a small animal experiment without a reported sample size, so it gives weak evidence for humans
Limitations
animal (mouse) model, number of animals not stated, and tests Japanese honeys (acacia, buckwheat, Chinese milk vetch) rather than manuka honey or anorectal surgical wounds
Taken word for word from the abstract
- population cutaneous wound healing in 8-week-old, BALB/cCrSlc male mice
- intervention treated with 0.1 mL of the relevant type of honey until day 3 post-wound and then were covered with a HCD from days 4 to 14
- comparator The wounds of the control group were covered with a HCD
- primaryOutcome Reepithelialization, collagen deposition, and wound contraction
- result the wound area ratio was significantly smaller in the inflammatory phase but significantly larger in the proliferative phase. Reepithelialization, collagen deposition, and wound contraction were significantly delayed compared with those in the control group.
- result these methods do not promote cutaneous wound healing better than the use of a HCD alone
Wounds · PMID 27852015 · Read it on PubMed ↗
Woo et al. 2015
Topical Agents and Dressings for Pilonidal Sinus Wound Healing by Secondary Intention: A Scoping Review
Weak evidence honey may help healing.Systematic reviewVery low qualityRelated question
size not given2015
some evidence these treatments may help healing, reduce bacteria, or ease pain, but evidence is weak
Who was studied
people with pilonidal sinus wounds healing after surgery (open wound healing)
What they received
topical treatments like honey, silver, hydrogel, zinc, foam dressings, negative pressure therapy, platelet rich plasma, and plant extracts
Compared with
other dressings or standard wound care
Main outcome
wound healing, bacterial load, and wound pain
Quality
this is a scoping review of studies with acknowledged methodological limitations and biases, so conclusions are weak.
Limitations
evidence remains insufficient in light of methodological limitations and biases of the studies
Taken word for word from the abstract
- population pilonidal wound healing by secondary intention
- intervention topical applications of hydrogel, silver, honey, zinc, selected foam materials, negative pressure wound therapy, platelet rich plasma, and plant extracts
- primaryOutcome which topical agent or dressing is effective in promoting pilonidal wound healing by secondary intention
- result there is some evidence to suggest that topical applications of hydrogel, silver, honey, zinc, selected foam materials, negative pressure wound therapy, platelet rich plasma, and plant extracts may promote wound healing
- limitations evidence remains insufficient in light of methodological limitations and biases of the studies
- comparator Topical treatment using polyhexamethylene biguanide and silver may be beneficial in reducing bacterial burden
Surg Technol Int · PMID 26054992 · Read it on PubMed ↗
Mukai et al. 2015
Evaluation of the effects of a combination of Japanese honey and hydrocolloid dressing on cutaneous wound healing in male mice
Slowed wound healing in miceAnimal studyLow qualityRelated question
size not given14 days
Manuka honey plus dressing healed slower than dressing alone, with smaller wound closure and delayed reepithelialization and collagen deposition
Who was studied
mice with full-thickness skin wounds
What they received
Manuka honey plus hydrocolloid dressing
Compared with
hydrocolloid dressing alone
Main outcome
wound area, reepithelialization and collagen deposition during healing
Quality
small animal study without reported sample size, so results may not predict human wound healing
Limitations
Animal (mouse) model, sample size not reported, not human anorectal surgery setting
Taken word for word from the abstract
- population Mice were divided into four groups
- intervention Manuka (New Zealand) + HCD
- comparator HCD (control) groups
- primaryOutcome Wound area was significantly smaller in the HCD group than in the Acacia + HCD and Manuka + HCD groups on day 13 and days 8-14, respectively.
- result compared with the HCD group, reepithelialization was delayed in the Acacia + HCD group and reepithelialization and collagen deposition were delayed in the Chinese milk vetch + HCD and Manuka + HCD groups
- result these results indicate that the combined use of Japanese honey and HCD does not promote cutaneous wound healing compared with the use of HCD alone
Evid Based Complement Alternat Med · PMID 25945118 · Read it on PubMed ↗

What actually helps, on this site

Treatments Dr. Kamrava performs for this:

Hemorrhoidectomy

More about the condition:

All 142 studiesEvery study that answered the question, with its design, size and result.

The other 135 studiesEverything else the search returned, including anything retracted.

Putra et al. 2026
Development and preclinical evaluation of an Aceh kelulut honey-based hydrocolloid dressing for wound healing
Faster healing but slower skin regrowth.Animal studyLow qualityRelated question
27 people14 days
faster wound closure and improved inflammation control, wound contraction, and collagen deposition, but lower epithelialization in early phase compared to other groups
Who was studied
mice with surgically created skin wounds
What they received
Aceh kelulut honey-based hydrocolloid dressing
Compared with
pure Aceh kelulut honey and saline (0.9% NaCl) control
Main outcome
wound healing measured by wound closure size and tissue healing markers (inflammation, myofibroblasts, collagen, epithelialization)
Quality
This is a small animal study on mice, not humans, so it cannot directly tell us about human wound healing, especially after surgery.
Limitations
Small sample size (27 mice), animal model only, not anorectal surgery wounds, and epithelialization was worse in the treatment group early on.
Taken word for word from the abstract
- n Twenty-seven healthy male mice (Mus musculus) were assigned to three groups
- population Two full-thickness excisional wounds, each 4 mm in diameter, were created on the dorsal skin of each mouse.
- intervention Aceh kelulut honey-based hydrocolloid (KHHC)
- comparator control treated with 0.9% NaCl, pure Aceh kelulut honey (KH)
- primaryOutcome Wound diameter was measured daily for 14 days. Histopathological evaluation was performed on days 3, 7, and 14 to assess neutrophil and macrophage counts, epithelialization ratio, myofibroblast ratio, and collagen fiber density.
- result The KHHC group showed faster macroscopic wound closure than the KH and control groups.
- result However, epithelialization was lower in the KHHC group during the early healing phase.
Narra J · PMID 42724030 · Read it on PubMed ↗
Alhamdani et al. 2026
Formulation, nanoencapsulation and characterisation of mānuka oil and β-triketones for biomedical applications
Lab-made nanoparticles killed bacteria, not tested on wounds.Laboratory studyVery low qualityRelated question
size not given2026
Nanoparticles were successfully made, killed bacteria at certain concentrations, and did not harm cells in testing
Who was studied
not applicable (laboratory study, no patients)
What they received
manuka oil and β-triketone nanoparticles encapsulated in chitosan
Main outcome
nanoparticle characteristics, antimicrobial effect, and cell toxicity
Quality
This is a laboratory study of nanoparticle formulation with no patients or wounds tested, so it cannot show whether this helps wound healing in people.
Limitations
Study is in-vitro formulation and antimicrobial/biocompatibility testing only; no human or animal wound healing data reported.
Taken word for word from the abstract
- intervention We used ionic gelation to encapsulate MO and its derivative β-triketones (TK) within chitosan nanocarriers.
- primaryOutcome Nanoparticles were characterised for morphology, chemical composition, encapsulation efficiency and release profile. Antimicrobial properties and biocompatibility were evaluated.
- result Bactericidal effect was achieved at concentrations of 3.125-25.000 mg/ml, with no cytotoxic effect.
- population Mānuka oil (MO) is derived from mānuka shrubs in New Zealand (NZ) and presents antimicrobial properties
Nanomedicine · PMID 42641744 · Read it on PubMed ↗
Lopez et al. 2026
Bio-enhanced silk fibroin-based scaffolds for chronic diabetic foot ulcers
Barely mentioned, no real data given.Narrative reviewVery low qualityRelated question
size not given2026
review states a collagen-Manuka honey-hydroxyapatite patch has shown improved outcomes, but gives no specific data, population details, or comparison figures
Who was studied
patients with chronic diabetic foot ulcers
What they received
silk fibroin-based wound scaffolds enhanced with bio-additives (manuka honey mentioned only as part of one approved product)
Compared with
standard diabetic wound care treatments
Main outcome
wound healing and tissue regeneration in chronic diabetic foot ulcers
Quality
This is a narrative review focused on silk fibroin scaffolds that mentions a manuka honey product only in passing, without describing any specific study, data, or trial design for manuka honey itself.
Limitations
The abstract does not describe the studies behind the manuka honey product claim, and the review's main focus is silk fibroin scaffolds, not manuka honey; population is diabetic foot ulcers, not anorectal surgery.
Taken word for word from the abstract
- population Diabetic foot ulcers (DFUs) represent a growing clinical challenge
- intervention Silk fibroin (SF), a natural biopolymer with established clinical use, has emerged as a promising platform for chronic wound management
- comparator Standard treatments typically include pressure offloading, circulation improvement, infection control, and topical wound care
- primaryOutcome modulate cellular responses, redirect dysregulated healing pathways, accelerate wound closure, and promote tissue regeneration in diabetic wounds
- result products such as the collagen-Manuka honey-hydroxyapatite patch from SweetBio (Apis®) have demonstrated improved outcomes in patients with chronic ulcers
Burns Trauma · PMID 42544260 · Read it on PubMed ↗
Fang et al. 2026
Impact of advanced wound care methods on obstetric patients: a meta-analysis
No significant difference overall.Meta-analysisLow qualityRelated question
1,977 people2026
pooled risk ratio of 0.97 (95% CI 0.81 to 1.16), no significant difference between groups
Who was studied
women with surgical wounds from obstetric procedures like C-sections and episiotomies
What they received
advanced wound care methods such as bioactive dressings, antimicrobials, and organic gels including honey, aloe vera, and turmeric
Compared with
standard wound care methods
Main outcome
wound healing
Quality
The studies pooled were highly variable (I2=78%) and mixed many different treatments together, including honey as just one of several options, so it's hard to know what any single treatment like manuka honey does.
Limitations
Substantial heterogeneity across studies (I2=78%); pooled multiple different AWC interventions together rather than isolating honey specifically; population is obstetric wounds, not anorectal surgery wounds.
Taken word for word from the abstract
- n A total of 11 studies comprising 1977 patients were analysed.
- population Obstetric procedures, including caesarean sections and episiotomies, often result in surgical wounds requiring effective management to prevent complications.
- intervention Advanced wound care (AWC) methods-such as bioactive dressings, topical antimicrobials and medicated creams-are increasingly used to enhance healing outcomes.
- intervention AWC methods, including organic gels (e.g., aloe vera, honey, turmeric), antibiotic dressings, and topical formulations were associated with improved wound healing in several studies.
- comparator This meta-analysis aimed to quantitatively assess the efficacy of AWC interventions compared to standard methods in obstetric patients.
- primaryOutcome pooled to assess wound healing efficacy
- result the pooled risk ratio was 0.97 with a 95% confidence interval of 0.81 to 1.16, indicating no statistically significant difference between AWC and standard treatments
J Wound Care · PMID 42247330 · Read it on PubMed ↗
Sinha et al. 2026
Fabrication and Characterization of Silk-Fibroin, Polyvinyl Alcohol, and Natural Compounds-Derived Bioscaffold to Accelerate Wound Healing
Lab material shows wound-healing potential, untested in people.Laboratory studyVery low qualityRelated question
size not given2026
the scaffold was non-toxic, improved cell migration and proliferation, and showed strong antioxidant activity in lab tests
Who was studied
human umbilical vein endothelial cells and lab assays (not patients)
What they received
a bioscaffold made of silk fibroin, polyvinyl alcohol, manuka honey, fenugreek extract, and ghrelin
Compared with
no comparator described beyond assay controls
Main outcome
cell toxicity, migration, proliferation, and antioxidant activity in lab tests
Quality
this is a cell and material science lab study, not a test in humans, so it cannot show whether this helps real wounds heal.
Limitations
lab-only in-vitro testing with no animal or human wound data, and honey is only one of several combined ingredients so its individual effect cannot be separated
Taken word for word from the abstract
- population Scratch assays confirmed enhanced migration of human umbilical vein endothelial cells
- intervention Polyvinyl alcohol and silk fibroin formed the scaffold matrix, blended with Manuka honey, fenugreek seed extract, and Ghrelin for their antioxidant and proangiogenic properties.
- primaryOutcome The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay confirmed the absence of toxicity. Scratch assays confirmed enhanced migration of human umbilical vein endothelial cells, supporting the scaffold's angiogenic potential.
- result Additionally, the scaffold exhibited superior antioxidant activity and significantly improved cell proliferation.
- comparator BACKGROUND: Impaired wound healing represents a significant clinical challenge.
Front Biosci (Landmark Ed) · PMID 42216526 · Read it on PubMed ↗
Alhabsi et al. 2026
Clinical and Postoperative Applications of Manuka Honey in Wound Healing: An Evidence-Based Review
May help wounds heal fasterNarrative reviewVery low qualityRelated question
size not given2026
reduced bacterial load, faster healing and improved comfort reported across clinical studies
Who was studied
patients with chronic or postoperative surgical wounds
What they received
Manuka honey applied to wounds
Compared with
not clearly specified across included studies
Main outcome
wound healing, infection control and bacterial load
Quality
this is a narrative review of mixed study types without statistical pooling, and it admits that robust high-quality surgical trials are still needed.
Limitations
the abstract itself calls for standardised protocols and robust, high-quality surgical trials, indicating the current evidence base is not strong or consistent
Taken word for word from the abstract
- population Chronic and postoperative wounds remain challenging to manage
- intervention Manuka honey offers antibacterial, anti-inflammatory, antioxidant and tissue-regenerative properties
- comparator A narrative review of PubMed, Scopus and Google Scholar identified studies on surgical site management, graft or flap bed preparation, chronic wounds and novel delivery systems
- primaryOutcome Clinical studies show reduced bacterial load, faster healing and improved comfort in surgical and chronic wounds.
- result Clinical studies show reduced bacterial load, faster healing and improved comfort in surgical and chronic wounds.
- design A narrative review of PubMed, Scopus and Google Scholar identified studies
- limitations Standardised application protocols and robust, high-quality surgical trials are urgently needed to confirm its effective role in perioperative clinical practice.
Int Wound J · PMID 42117760 · Read it on PubMed ↗
Molga-Chlipała et al. 2026
Honey-based dressing vs gelatin sponge for palatal wound healing after free gingival graft harvest: A randomized clinical trial
Comparable healing to gelatin sponge.Randomised trialLow qualityRelated question
21 people14 days
no significant difference between honey and gelatin sponge dressings in pain, discomfort, or healing at 14 days
Who was studied
patients with gum recession needing palate graft surgery for dental treatment
What they received
Manuka honey-coated dressing on the palate wound
Compared with
gelatin sponge dressing on the palate wound
Main outcome
pain, discomfort, burning sensation, diet changes, and wound healing after surgery
Quality
very small study with only 21 patients comparing two dressings, not honey versus no treatment, on a different kind of wound than anorectal surgery
Limitations
small sample size of 21 patients; split-mouth design in dental surgery, not anorectal surgery; no untreated comparison group
Taken word for word from the abstract
- n A total of 21 patients (16 females and 5 males) with multiple gingival recessions (GR) were treated
- population A total of 21 patients (16 females and 5 males) with multiple gingival recessions (GR) were treated
- intervention a non-adherent viscose net dressing coated with 99% Manuka honey and 1% Manuka oil (Actilite; Advancis Medical, Kirkby-in-Ashfield, UK)
- comparator an absorbable hemostatic porcine gelatin sponge (Aegis Lifesciences, Sanand, India)
- primaryOutcome The palatal donor sites were evaluated at 1, 2, 4, 7, and 14 days postoperatively for pain, patient discomfort, changes in dietary habits, and burning sensation.
- result no significant differences were observed in postoperative pain, patient discomfort, burning sensation, or changes in dietary habits at 14 days postoperatively (p > 0.05)
Adv Clin Exp Med · PMID 42087593 · Read it on PubMed ↗
Kang 2026
Manuka Honey in Craniofacial Wound Management: A Narrative Review
Mostly weak, supportive evidence only.Narrative reviewVery low qualityRelated question
size not given2026
most evidence came from case reports and small series, with only one randomized controlled trial in head and neck wounds
Who was studied
people with craniofacial wounds (scalp, head and neck, facial surgical wounds)
What they received
Manuka honey applied to wounds
Main outcome
evidence supporting wound healing use of Manuka honey
Quality
this is a narrative review built mostly from case reports and small series rather than controlled trials, so it can't reliably show whether honey works.
Limitations
abstract states most available evidence remains at the level of case reports and small series, with only one randomized controlled trial conducted specifically in head and neck wounds
Taken word for word from the abstract
- population Craniofacial wounds present unique management challenges owing to the aesthetic significance of the facial region
- intervention Manuka honey, derived from the Leptospermum scoparium plant, possesses well-documented antimicrobial, anti-inflammatory, and wound healing properties
- primaryOutcome Evidence supporting the use of Manuka honey in the craniofacial region was identified across several wound categories, including scalp defects with exposed calvarium, head and neck oncologic reconstruction wounds, oral and maxillofacial infections, partial flap necrosis, facial surgical wounds, and burns.
- result Most available evidence remains at the level of case reports and small series, with only one randomized controlled trial conducted specifically in head and neck wounds.
J Craniofac Surg · PMID 42084260 · Read it on PubMed ↗
Anetekhai et al. 2026
Effectiveness of Biodress versus both honey and povidone-iodine ointment in acute wound healing in Enugu State, Nigeria: a randomised controlled trial
No overall difference; worse than Biodress for burns.Randomised trialLow qualityRelated question
42 people2026
no significant difference between honey, Biodress and povidone-iodine on wound closure overall, but Biodress showed an advantage over honey specifically for burns
Who was studied
adults with acute wounds treated at two hospitals in southeast Nigeria
What they received
honey dressing
Compared with
petroleum-based Biodress dressing and povidone-iodine ointment
Main outcome
wound closure
Quality
Very small single-blinded trial (42 patients) comparing honey of unspecified type to other dressings, not manuka honey specifically.
Limitations
Small sample size, honey type not specified as manuka, population is general acute wounds (including burns) rather than anorectal surgery patients.
Taken word for word from the abstract
- n A total of 42 patients were included in this RCT
- population A single-blinded randomised controlled trial (RCT) was performed among patients with acute wounds selected from two hospitals in southeast Nigeria.
- intervention honey or povidone-iodine which were used as two independent control groups
- comparator the petroleum-based dressing used as the intervention
- primaryOutcome No significant difference was observed in the effectiveness of the petroleum-based dressing over honey or povidone-iodine ointment on wound closure
- result No significant difference was observed in the effectiveness of the petroleum-based dressing over honey or povidone-iodine ointment on wound closure (p=0.288). However, considering injury type, Biodress showed some advantage over honey in burns injuries (p=0.017).
J Wound Care · PMID 42068250 · Read it on PubMed ↗
Rojczyk et al. 2026
Manuka honey as a natural remedy for diabetic foot ulcers: efficacy compared with silver-based dressing
Better healing than silver dressingsRandomised trialLow qualityRelated question
60 people4 weeks
Manuka honey group showed significantly greater wound improvement than silver dressing group, with total score reduced by 41.3% vs 2.0%
Who was studied
patients with diabetic foot ulcers
What they received
medical-grade Manuka honey dressing
Compared with
silver-containing calcium alginate dressing
Main outcome
wound healing progress measured by RESVECH 2.0 score after 4 weeks
Quality
small randomized trial of only 60 patients with a short 4-week follow-up limits confidence in the findings.
Limitations
Small sample size and short follow-up period of only 4 weeks; studies diabetic foot ulcers, not anorectal surgical wounds.
Taken word for word from the abstract
- population two groups of patients (a total of 60 individuals) with DFUs
- intervention the experimental group received treatment with medical-grade Manuka honey
- comparator the control group was treated with a silver-containing calcium alginate dressing
- primaryOutcome RESVECH 2.0 Scoring Table was used twice (just before procedure and after 4 weeks) to assess treatment effectiveness
- result Total score was reduced by 41.3% in the experimental group vs. 2.0% in the control group
- n a total of 60 individuals
Front Pharmacol · PMID 41982668 · Read it on PubMed ↗
Costa et al. 2026
Gellan gum/honey-based gels and hydrogels for cutaneous wound management
Promising lab results, not tested in people.Laboratory studyVery low qualityRelated question
size not given2026
Honey-gellan gum gels showed good wound debridement and sustained release properties; cells initially slowed but then recovered proliferation and migration
Who was studied
Laboratory study developing wound-care gels, not tested in patients
What they received
Gellan gum combined with multiflora honey formed into gels and hydrogels
Compared with
Different gel/hydrogel formulations with varying honey and gellan gum concentrations compared to each other
Main outcome
Physical properties, antimicrobial activity, and effects on cell growth/migration in lab tests
Quality
This is early-stage laboratory and cell-culture work, not a study in real wounds or patients, so it cannot show whether the honey gel actually helps people heal.
Limitations
No human or animal wound testing; honey used was multiflora (not manuka); results based only on lab material testing and cell culture.
Taken word for word from the abstract
- population Wound healing is complex and still requires targeted therapies and advanced dressings despite current advances.
- intervention combines a previously uncharacterized multiflora HNY from Monte Novo (Portalegre, Portugal) with gellan gum (GG) to develop gels for osmolarity-driven debridement and hydrogels for sustained release of bioactive components post-debridement
- comparator Gels were prepared using 0.1 and 0.2% GG with 50-90% HNY
- primaryOutcome All gel formulations were extrudable and demonstrated effective water absorption.
- result Although initial HNY hydrogel exposure reduced cell metabolic activity, cells recovered over time, maintaining proliferation and migratory function.
Int J Pharm · PMID 41956357 · Read it on PubMed ↗
Yao et al. 2026
Honey dressing for diabetic foot ulcers: a systematic review and meta-analysis of randomized controlled trials
Faster, more complete healing of foot ulcersMeta-analysisLow qualityRelated question
1,423 people4 to 24 weeks
honey dressing improved complete healing rate and reduced healing time compared to conventional dressings
Who was studied
people with diabetic foot ulcers
What they received
honey dressing
Compared with
conventional wound dressings
Main outcome
complete wound healing rate and time to complete healing
Quality
the review itself graded the evidence as low to moderate quality using GRADE
Limitations
evidence quality graded low for time to healing and moderate for healing rate; not manuka honey specifically and not anorectal surgery wounds
Taken word for word from the abstract
- n Sixteen RCTs involving 1423 participants were included
- population honey dressing with conventional dressings in DFU patients
- intervention honey dressing
- comparator conventional dressings
- primaryOutcome Primary outcomes were complete wound healing rate and time to complete healing
- result honey dressing significantly improved the complete healing rate (OR 2.28, 95% CI 1.76 to 2.95) and reduced the time to complete healing (MD -4.38, 95% CI -8.06 to -0.71) compared to controls
- followUp The follow-up duration varied from 4 to 24 weeks
Front Endocrinol (Lausanne) · PMID 41928876 · Read it on PubMed ↗
Wulandari et al. 2026
Topical honey as adjunctive therapy to standard dressing in deep neck abscess: a single-blind randomized controlled trial
Similar healing, better inflammation markers.Randomised trialLow qualityRelated question
size not given2026
comparable clinical outcomes to standard dressings, with greater reductions in inflammatory markers and increased VEGF expression
Who was studied
patients with deep neck abscess
What they received
standard wound dressing plus honey
Compared with
standard wound dressing alone
Main outcome
wound size, inflammation markers, pain, and healing-related measures
Quality
The abstract does not report the number of patients, and the trial was only single-blind with outcomes based partly on biomarkers rather than confirmed clinical healing differences.
Limitations
Abstract does not specify participant numbers, honey type (not stated as manuka), or blinding beyond single-blind design; population is deep neck abscess, not anorectal surgery wounds.
Taken word for word from the abstract
- population patients with DNA
- intervention standard dressing supplemented with honey
- comparator standard dressing
- primaryOutcome wound size, Bates-Jensen Wound Assessment Tool (BWATs) scores, Visual Analog Scale (VAS), white blood cell (WBC) count, bacterial colony growth, and expression of interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), and vascular endothelial growth factor (VEGF)
- result Honey supplementation showed comparable clinical outcomes to standard dressings, demonstrated greater reductions in inflammatory markers (IL-1, TNF-α) and increased VEGF expression.
- design A single-blind randomized controlled trial was conducted
Acta Otolaryngol · PMID 41841442 · Read it on PubMed ↗
He et al. 2026
The efficacy of three antimicrobial dressings in the management of diabetic foot ulcers: a systematic review and network meta-analysis
Honey results not specifically reported.Meta-analysisModerate qualityRelated question
1,292 people2026
The abstract reports that antibiotic bone cement and silver dressings healed wounds faster and better than standard care, but it does not give specific comparative results for honey dressings.
Who was studied
People with diabetic foot ulcers
What they received
Honey dressings, silver dressings, or antibiotic-impregnated bone cement for foot ulcers
Compared with
Standard wound care
Main outcome
Wound healing rate and healing time
Quality
It pools 15 randomized trials with over a thousand patients, but does not separately report how honey dressings performed and relies on indirect network comparisons.
Limitations
The abstract does not report individual trial quality, does not give specific results for honey dressings versus other treatments, and studies diabetic foot ulcers rather than anorectal surgical wounds.
Taken word for word from the abstract
- population A total of 15 RCTs encompassing 1,292 patients were included.
- intervention comparing silver dressings, honey dressings, and ABC in the treatment of DFU
- comparator ABC demonstrated superiority over standard care in both healing rate and healing time
- primaryOutcome healing rate and healing time
- result ABC demonstrated superiority over standard care in both healing rate and healing time (OR = 4.06, 95% CI [1.48, 11.1], P < 0.05; SMD = -2.25, 95% CI [-4.11, -0.40], P < 0.05). Silver dressings also outperformed standard care in terms of healing rate and wound area reduction (OR = 2.31, 95% CI [1.14, 4.69], P < 0.05; SMD = 1.43, 95% CI [0.39, 2.47], P < 0.05).
- n A total of 15 RCTs encompassing 1,292 patients were included.
Front Endocrinol (Lausanne) · PMID 41816212 · Read it on PubMed ↗
Tsaku et al. 2025
A randomised controlled trial of raw honey for the healing of ulcers in leprosy in Nigeria
No significant benefit over saline.Randomised trialModerate qualityRelated question
130 people6 months
no significant difference in healing between honey and saline, though honey showed a non-significant trend toward faster healing
Who was studied
people with leprosy-related foot ulcers in Nigeria
What they received
raw honey wound dressings
Compared with
standard saline dressings
Main outcome
complete ulcer healing by 84 days and rate of healing
Quality
it was a randomised trial but was single-blinded, modest in size, and found no statistically significant benefit.
Limitations
single-blinded design, non-significant trend only, leprosy ulcers not anorectal surgical wounds
Taken word for word from the abstract
- n A total of 130 participants were randomised in the study.
- population leprosy-associated foot ulcers in Nigeria
- intervention raw honey dressings (n = 65)
- comparator standard saline dressings (n = 65)
- primaryOutcome Primary outcomes were complete healing by 84 days and healing rate, assessed through blinded digital planimetry.
- result Complete healing occurred in 29.2% of honey-treated ulcers versus 24.6% with saline (adjusted HR 1.26, 95% CI 0.64-2.47).
- result The honey group showed a non-significant trend toward faster healing (p = 0.076).
PLoS Negl Trop Dis · PMID 41474823 · Read it on PubMed ↗
Hariyudo et al. 2025
The Elimination Effect of Medical-Grade Honey on Pseudomonas aeruginosa Biofilms: A Systematic Review and Meta-Analysis
Honey kills bacterial biofilms in lab dishes.Meta-analysisLow qualityRelated question
size not given2025
medical-grade honey significantly reduced biofilm formation and disrupted established biofilms compared to controls
Who was studied
Pseudomonas aeruginosa biofilms grown in lab experiments (in vitro), not patients
What they received
medical-grade honey (including Manuka and Surgihoney) applied to bacterial biofilms
Compared with
untreated biofilm controls, sugar solutions, and methylglyoxal alone
Main outcome
reduction and disruption of bacterial biofilm formation
Quality
This is a meta-analysis of only in vitro lab experiments on bacteria, not on real wounds or patients, so it cannot show whether honey helps people heal.
Limitations
Only in vitro studies included; sterility control comparisons showed high variability; based on six studies with subgroup heterogeneity.
Taken word for word from the abstract
- population in vitro studies assessing MGH's effect on P. aeruginosa biofilms
- intervention All studies evaluated the effect of MGH, including Manuka and Surgihoney, on P. aeruginosa biofilms
- comparator MGH also demonstrated significant superiority compared to active biofilm controls
- comparator Medihoney outperformed sugar solutions and methylglyoxal (MGO) alone
- primaryOutcome reported outcomes including biofilm inhibition and eradication
- result Pooled results showed that MGH significantly reduced biofilm formation (standardized mean difference (SMD) = -4.98; 95% confidence interval (CI): -6.72 to -3.25) and effectively disrupted established biofilms (SMD = -4.44; 95% CI: -6.62 to -2.26).
J Clin Med Res · PMID 40958987 · Read it on PubMed ↗
Wulandari et al. 2025
Honey as a Wound Care Modality in Treating Deep Neck Space Abscesses: Protocol for a Randomized Controlled Trial
No results yet, protocol only.Registered trial, no results postedVery low qualityRelated question
36 people2025
This is a study protocol; no results are reported in this abstract
Who was studied
patients with deep neck space abscesses
What they received
honey dressings added to standard wound dressings
Compared with
standard dressings alone
Main outcome
wound healing measures including cytokines, growth factors, wound size, and bacterial colonies
Quality
This is only a trial protocol with no outcome data yet reported.
Limitations
No results are available; this abstract only describes the planned methods and recruitment status.
Taken word for word from the abstract
- n There are 18 participants in each group.
- population all patients with deep neck abscesses treated at Dr Sardjito General Hospital
- intervention Participants in the intervention group received standard dressings in addition to honey dressings
- comparator those in the control group received standard dressings alone
- primaryOutcome Proinflammatory cytokines and growth factors, wound size, Bates-Jensen Wound Assessment Tools scoring, and quantitative bacterial colony identification will be all evaluated and assessed.
- result This manuscript presents a study protocol for a randomized controlled trial investigating honey as a wound care modality in patients with deep neck space abscesses.
JMIR Res Protoc · PMID 40810438 · Read it on PubMed ↗
Boateng et al. 2025
Composite HPMC-Gelatin Films Loaded with Cameroonian and Manuka Honeys Show Antibacterial and Functional Wound Dressing Properties
Lab test: honey film fights bacteria.Laboratory studyVery low qualityRelated question
size not given2025
honey films showed increased antibacterial inhibition zones and changed physical properties with higher honey concentration, with similar performance between honey types
Who was studied
not applicable - laboratory wound dressing film study, not human patients
What they received
honey-loaded hydrocolloid film (gelatin and HPMC) containing Cameroonian or Manuka honey
Compared with
films with different honey concentrations (1% vs 5% w/v) and different honey sources compared to each other
Main outcome
film physical properties (tensile strength, stickiness, moisture handling) and antibacterial activity against wound bacteria
Quality
this is a laboratory material-science study on films in vitro, not a clinical study on patients or wounds healing in the body.
Limitations
laboratory in-vitro study only; no human or animal wound healing tested; not related to anorectal surgery or clinical outcomes
Taken word for word from the abstract
- population formulate honey-loaded hydrocolloid film comprising gelatin and HPMC, for potential treatment of infected chronic wounds
- intervention Honeys from different sources (Cameroonian and Manuka) were used as the bioactive ingredients
- comparator zones of inhibition (2.4-6.5 mm) increased with increasing honey concentration for 1 and 5% w/v, respectively
- primaryOutcome Antibacterial susceptibility testing was performed to study the inhibition of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus by honey components released from the films
- result The results generally showed similar performance for the different honeys and demonstrate the efficacy of honey-loaded hydrocolloid films as potential wound dressing against bacterial growth and potential treatment of infected chronic wounds.
Gels · PMID 40710718 · Read it on PubMed ↗
Jain et al. 2025
A Study of Effect of Manuka Honey Healing in Post Operative Fess Surgery
Faster nasal healing reportedCase seriesVery low qualityRelated question
50 people2025
median time to clean cavity, mucosal transition and complete healing was 14 days
Who was studied
patients who had surgery for sinus disease (post endoscopic sinus surgery)
What they received
manuka honey applied to the nose after surgery
Compared with
no comparison group reported
Main outcome
time to heal of the nasal lining after surgery
Quality
this was a small study of 50 patients with no comparison group, so it can't show whether honey actually sped healing versus no treatment
Limitations
no control or comparator group was described, and the study looked at sinus surgery, not anorectal surgery
Taken word for word from the abstract
- n A total of 50 patients were selected
- population patients were selected and were operated for sinonasal diseases
- intervention Post operative after nasal pack removal manuka honey was applied
- comparator A total of 50 patients were selected and were operated for sinonasal diseases.
- primaryOutcome The median time to achieve clean cavity, mucosal transition and complete epithelialization was 14.0 (14.0-14.0) days.
- result The median time to achieve clean cavity, mucosal transition and complete epithelialization was 14.0 (14.0-14.0) days.
Indian J Otolaryngol Head Neck Surg · PMID 40066391 · Read it on PubMed ↗
Kucharzewski et al. 2025
Topical Application of Manuka Honey for the Treatment of Non-Healing Venous Leg Ulcers
Faster healing than silver dressing.Randomised trialLow qualityRelated question
80 peopleup to 14 weeks
ulcers healed in up to 7 weeks with Manuka honey versus up to 14 weeks with the silver dressing
Who was studied
patients with chronic non-healing venous leg ulcers
What they received
topical Manuka honey application with compression bandage
Compared with
antimicrobial calcium alginate wound dressing with silver
Main outcome
time to complete wound healing
Quality
Although randomized, this is a small single study in leg ulcer patients, not anorectal surgery patients, with limited detail on blinding or statistical analysis.
Limitations
Abstract does not report blinding, statistical significance testing, or dropout rates.
Taken word for word from the abstract
- n Eighty patients with chronic VLU participated in the study
- population patients with chronic VLU participated in the study
- intervention patients were treated with topical Manuka honey application and short stretch bandage compression
- comparator antimicrobial calcium alginate wound dressing + Ag was used instead of Manuka honey
- primaryOutcome The aim of the study was to investigate the effectiveness of Manuka honey for the topical treatment of non-healing, chronic, venous leg ulcers.
- result The ulcerations in patients from group 1 have healed completely after up to seven weeks of therapy in all cases. In contrast, in all patients from group 2, the healing process was longer but completed successfully after up to 14 weeks of the therapy.
Pharmaceuticals (Basel) · PMID 40005964 · Read it on PubMed ↗
Brus et al. 2024
Case report: Surgical closure of a facial defect in an African wild dog (Lycaon pictus) utilizing a transpositional skin flap
Found a benefitCase seriesVery low qualityRelated question
1 people9 days
wound developed healthy granulation tissue within 9 days and was then surgically closed with good cosmetic outcome and successful pack reintegration
Who was studied
a zoo-housed African wild dog with a facial wound from suspected envenomation
What they received
topical manuka honey with bandaging, followed by surgical skin flap closure
Compared with
none
Main outcome
wound healing and return to pack
Quality
this is a single animal case report, not a controlled study, so it cannot show whether the honey itself caused the improvement
Limitations
single case, no control group, species is a wild dog not a human surgical patient, honey combined with surgery and bandaging so individual effect unclear
Taken word for word from the abstract
- n a three-year-old male intact zoo-housed African wild dog
- population a three-year-old male intact zoo-housed African wild dog (AWD) that presented with an episode of severe, acute, right-sided facial swelling
- intervention The resultant open wound was managed every other day with debridement and topical manuka honey covered with a tie-over bandage.
- comparator Rather than proceeding with second intention healing and continued bandage changes, a transpositional skin flap surgical procedure was performed
- primaryOutcome resulted in a healthy granulation tissue bed 9 days following initial debridement
- result resulted in a healthy granulation tissue bed 9 days following initial debridement
Front Vet Sci · PMID 39840331 · Read it on PubMed ↗
Mahmod et al. 2025
Investigating the efficacy of gellan gum hydrogel films infused with Acacia stingless bee honey in wound healing
Helped cells heal in lab dish.Laboratory studyVery low qualityRelated question
size not given72 h
The 20% honey formulation showed the highest wound closure rate, improved cell migration and proliferation, and no toxic effects on cells
Who was studied
Lab-based study using mouse fibroblast cells (3T3-L1) and E. coli bacteria, not human patients
What they received
Gellan gum hydrogel films infused with acacia stingless bee honey at different concentrations (10%, 15%, 20%)
Compared with
Gellan gum hydrogel films without honey or different honey concentrations compared to each other
Main outcome
Wound healing properties including cell migration, cell viability, and antibacterial activity in lab tests
Quality
This is an early-stage lab experiment on cells and bacteria, not people, so it cannot show whether this would help real wounds heal.
Limitations
This is in-vitro (lab dish) research only, uses a different honey type (acacia stingless bee honey, not manuka), and has not been tested in humans or animals with real wounds, let alone after anorectal surgery.
Taken word for word from the abstract
- population Cytotoxicity assessments (MTT and scratch assays) on 3 T3-L1 cells confirmed the biocompatibility of GGSBH
- intervention GG hydrogel films incorporated with varying concentrations of SBH (v/v) at 10 % (GGSBH10), 15 % (GGSBH15), and 20 % (GGSBH20) were characterized.
- comparator Among the formulations, GGSBH20 demonstrated an impressive water vapor transmission rate
- primaryOutcome Notably, GGSBH20 displayed the highest wound closure rate, significantly enhancing cell migration and proliferation.
- result Notably, GGSBH20 displayed the highest wound closure rate, significantly enhancing cell migration and proliferation.
- followUp no cytotoxic effects up to 72 h of incubation
Int J Biol Macromol · PMID 39800021 · Read it on PubMed ↗
Gallagher et al. 2024
Expediting acute wound healing by integrating multiple therapeutic strategies: a case series
Can't isolate honey's effect.Case seriesVery low qualityRelated question
124 people2024
median healing time was 19 days with multimodal combination therapy
Who was studied
patients with acute traumatic wounds
What they received
combination wound therapy including hypochlorous acid cleanser, negative pressure therapy, collagen, silver, manuka honey, and/or foam dressings
Compared with
none reported - single group, no comparison arm
Main outcome
time to wound healing
Quality
This is a small observational case series with no control group, and manuka honey was just one of several treatments used together, so its individual effect cannot be determined.
Limitations
No comparator group; manuka honey was combined with multiple other treatments (hypochlorous acid, negative pressure therapy, collagen, silver, foam dressings) so its individual contribution cannot be isolated; population was general acute wounds, not anorectal surgery patients.
Taken word for word from the abstract
- n A total of 124 patients with acute wounds up to 1120 cm3 healed using multimodal therapy.
- population Traumatic injuries have increased risks for infection and progression to difficult-to-heal wounds.
- intervention all patients were treated with a pure hypochlorous acid-based wound cleanser combined with negative pressure wound therapy, collagen, silver, manuka honey, and/or foam dressings
- comparator An observational, prospective analysis was performed, reviewing patients with acute wounds from admission until healed.
- primaryOutcome Key outcomes included wound progression, dimensions, treatments, healing time, and health care utilization metrics.
- result Median healing time was 19 days.
Wound Manag Prev · PMID 39788879 · Read it on PubMed ↗
Tanasov et al. 2025
[Ulcers and diabetic foot : Modern and alternative treatment strategies]
Honey mentioned, no data givenNarrative reviewVery low qualityRelated question
size not given2025
abstract only states honey dressings have been reported as used successfully, with no specific data given
Who was studied
people with treatment-refractory diabetic foot ulcers
What they received
honey dressings (one of several alternative therapies discussed)
Main outcome
healing of treatment-refractory diabetic foot ulcers
Quality
this is a narrative review that only mentions honey dressings in passing as a literature report, with no study details, numbers, or outcome data provided.
Limitations
abstract gives no details on study design, patient numbers, type of honey used, or specific outcomes for honey dressings; it is a general review of diabetic foot ulcer treatments, not a study of manuka honey or anorectal surgery.
Taken word for word from the abstract
- population treatment-refractory ulcers
- intervention honey dressings
- primaryOutcome diabetic foot ulcers that may be suitable for treatment-refractory ulcers
- result There are also literature reports of alternative treatments (e.g., maggot debridement, honey dressings, acupuncture) that have been used successfully for treatment-refractory ulcers
Dermatologie (Heidelb) · PMID 39690198 · Read it on PubMed ↗
Kheradvar Kolour et al. 2024
Janus Films Wound Dressing Comprising Electrospun Gelatin/PCL Nanofibers and Gelatin/Honey/Curcumin Thawed Layer
Honey-based dressing helped wounds heal (animals).Animal studyVery low qualityRelated question
size not given2024
the honey/curcumin bilayered dressing promoted wound closure, collagen production, tissue granulation, immune response, and re-epithelialization compared to the commercial dressing
Who was studied
wounds in an in vivo animal study (species not specified)
What they received
a bilayered wound dressing made of gelatin/PCL nanofiber film combined with a gelatin hydrogel containing honey and curcumin
Compared with
a commercial wound dressing
Main outcome
wound healing, including wound closure, collagen production, tissue granulation, and re-epithelialization
Quality
This is a small animal/lab study testing a combined honey-curcumin-nanofiber dressing without reporting sample size, so it cannot show whether honey itself caused the effect or support use in human wound care.
Limitations
No sample size reported, honey is combined with curcumin and synthetic nanofiber/hydrogel layers so honey's individual contribution is unclear, and this is an animal study not involving anorectal surgery patients.
Taken word for word from the abstract
- intervention a bilayered electrospun/hydrogel gelatin-based scaffold integrated with honey and curcumin was developed to treat wounds under an in vivo study
- comparator the bilayered wound dressing was compared to a commercial wound dressing in an in vivo study
- primaryOutcome MTT and histopathological staining demonstrated that the bilayered wound dressing promoted wound closure accelerated collagen production and tissue granulation, and promoted immune system response and re-epithelialization compared to other groups
- result the bilayered wound dressing promoted wound closure accelerated collagen production and tissue granulation, and promoted immune system response and re-epithelialization compared to other groups
- population compared to a commercial wound dressing in an in vivo study
ACS Appl Bio Mater · PMID 39676562 · Read it on PubMed ↗
Jha et al. 2025
Glycyrrhizic Acid-Loaded Poloxamer and HPMC-Based In Situ Forming Gel of Acacia Honey for Improved Wound Dressing: Formulation Optimization and Characterization for Wound Treatment
Faster wound healing in animals.Animal studyLow qualityRelated question
size not given15 days
complete wound closure within 15 days of treatment and accelerated development of the extracellular matrix
Who was studied
experimental animal models with wounds
What they received
in situ hydrogel
Compared with
standard treatments
Main outcome
wound healing
Quality
This is an early-stage animal and lab study of acacia honey, not manuka honey, and not in human anorectal surgery patients, so it gives only indirect, low-certainty evidence.
Limitations
Animal study only, no human trial, uses acacia honey combined with another compound rather than manuka honey alone, and participant/animal numbers are not reported.
Taken word for word from the abstract
- population in vivo wound-healing studies in experimental animal models
- intervention codeliver acacia honey and glycyrrhizic acid for topical application
- comparator compared to the standard treatments
- primaryOutcome accelerate wound healing
- result complete wound closure within 15 days of treatment and accelerated development of the extracellular matrix
ACS Appl Bio Mater · PMID 39657741 · Read it on PubMed ↗
Zhang et al. 2024
Autologous platelet-rich fibrin enhances skin wound healing in a feline trauma model
Honey matched PRF for healingAnimal studyVery low qualityRelated question
18 peopledays 7, 14, 21, and 28
PRF-treated wounds healed comparably to manuka honey-treated wounds, both showing accelerated healing versus plain assessment
Who was studied
Cats with experimentally created traumatic skin wounds
What they received
Platelet-rich fibrin (PRF) applied to the wound
Compared with
Manuka honey applied as a positive control
Main outcome
Rate and quality of skin wound healing (healing rate, histology, growth factors, inflammation, collagen formation)
Quality
This is a very small animal (cat) experiment, not a human trial, so it offers only indirect, low-certainty evidence for people.
Limitations
Small number of animals per group (n=6), non-human species, and a trauma wound model rather than human surgical/anorectal wounds.
Taken word for word from the abstract
- population The models of feline trauma were effectively established.
- population A total of 18 cats were randomly divided into 3 groups (n = 6)
- intervention Platelet-rich fibrin (PRF), a platelet and leukocyte concentrate containing multiple cytokines and growth factors, is known to accelerate the healing of wounds.
- comparator Manuka honey group (MAN, as a positive control)
- primaryOutcome The study aimed to examine the impact of PRF on skin wound healing in the cat trauma model.
- result The outcomes of the PRF and MAN groups were comparable.
- n A total of 18 cats were randomly divided into 3 groups (n = 6)
- followUp Experiments were performed separately on days 7, 14, 21, and 28.
BMC Vet Res · PMID 39508248 · Read it on PubMed ↗
Kenney et al. 2024
Evaluation of pain associated with the application of burn dressings
More pain, less opioid use.RetrospectiveLow qualityRelated question
size not given2024
Manuka honey had higher mean daily pain scores than silver sulfadiazine and lower opioid consumption than 5% SMS and NPWT only
Who was studied
patients with burn wounds receiving topical dressings
What they received
manuka honey dressing
Compared with
other burn dressings (5% sulfamylon solution, negative-pressure wound therapy, silver sulfadiazine, silver nylon)
Main outcome
daily and maximum pain scores and opioid use during dressing care
Quality
It is a retrospective study without reported patient numbers or control for confounding factors, so its findings are weak evidence.
Limitations
Retrospective design; abstract calls for further studies with validated pain tools and clinically relevant endpoints.
Taken word for word from the abstract
- population the daily and maximum pain reported by patients and daily opioid consumption
- intervention manuka honey
- comparator 5% sulfamylon solution (SMS), manuka honey, negative-pressure wound therapy (NPWT), silver sulfadiazine, and silver nylon
- primaryOutcome the daily and maximum pain reported by patients and daily opioid consumption
- result silver sulfadiazine had lower mean daily pain scores compared only to manuka honey as well as lower maximum scores when compared to all other dressings except silver nylon. Furthermore, the choice of dressing did not have an overwhelming effect on the amount of opioids consumed by patients during their hospital stay with manuka honey having less opioid consumption when compared to only 5% SMS and NPWT only.
Int J Burns Trauma · PMID 39310249 · Read it on PubMed ↗
Gallo et al. 2024
Synergistic nanocoating with layer-by-layer functionalized PCL membranes enhanced by manuka honey and essential oils for advanced wound healing
Lab coating shows wound-healing promise, untested in patients.Laboratory studyVery low qualityRelated question
size not given2024
Coated membranes showed biocompatibility, expression of healing-related genes (VEGF, COL1, TGF-β1), and strong antibacterial activity against S. aureus and P. aeruginosa, with cinnamon oil enhancing bacterial inhibition
Who was studied
No human or animal patients; laboratory testing with fibroblast cells and bacterial strains
What they received
Electrospun PCL membranes coated with chitosan and manuka honey plus essential oil nanoemulsions (Layer-by-Layer coating)
Compared with
Different coating compositions (with and without cinnamon essential oil nanoemulsion)
Main outcome
Membrane characterization, biocompatibility, wound-healing gene expression, and antibacterial activity
Quality
This is an early-stage lab experiment on cells and bacteria, not a study in humans or animals with wounds, so it cannot show whether this helps real patients heal.
Limitations
No animal or human testing; only in-vitro cell and bacterial assays described
Taken word for word from the abstract
- population The coated membranes were tested in the presence of fibroblast cells
- intervention polycaprolactone membranes were manufactured using the electrospinning technique and subsequently coated with natural polyelectrolytes (chitosan as a polycation and a mixture of manuka honey with essential oils nanoemulsions as a polyanion) employing the Layer-by-Layer assembly technique
- comparator higher bacterial strain inhibition observed when cinnamon essential oil nanoemulsion was incorporated
- primaryOutcome demonstrating biocompatibility and expression of genes coding for VEGF, COL1, and TGF-β1, which are associated with the healing process
- result the membranes exhibited excellent antibacterial activity against both Staphylococcus aureus and Pseudomonas aeruginosa, with higher bacterial strain inhibition observed when cinnamon essential oil nanoemulsion was incorporated
Sci Rep · PMID 39237556 · Read it on PubMed ↗
Ngonzi et al. 2024
Outcomes of a honey and olive oil-based dressing material on wounds of women that have had a caesarean section in south-western Uganda
Faster healing, no complications seen.Case seriesVery low qualityRelated question
25 people2.2 (±0.7) days
No wound induration or dehiscence in any patient; 13% had wound discharge; average healing time 2.2 days
Who was studied
women who had caesarean section births in south-western Uganda
What they received
honey and olive oil-based wound dressing (I-Dress)
Compared with
none (no comparison group)
Main outcome
time taken for the wound to heal
Quality
This was a small uncontrolled case series with no comparison group, so it cannot show whether the dressing worked better than anything else.
Limitations
No control or comparator group; abstract does not mention blinding or randomization; this is a different population (caesarean section wounds) than anorectal surgery wounds.
Taken word for word from the abstract
- n A case-series study was conducted on 25 women who received I-Dress following caesarean births at three health facilities in south-west Uganda.
- population 25 women who received I-Dress following caesarean births at three health facilities in south-west Uganda
- intervention the study team created I-Dress, a wound dressing made of honey and olive oil
- comparator A case-series study was conducted on 25 women who received I-Dress following caesarean births at three health facilities in south-west Uganda.
- primaryOutcome The primary outcome was the length of time it took for the wound to heal.
- result all of the women (100%) had no wound induration or dehiscence, with only two (13%) experiencing wound discharge
- result The mean time required for wound healing was 2.2 (±0.7) days.
- followUp The mean time required for wound healing was 2.2 (±0.7) days.
Int Wound J · PMID 39211979 · Read it on PubMed ↗
Clare et al. 2024
The Potential of Fish Oil Components and Manuka Honey in Tackling Chronic Wound Treatment
Discusses potential, no outcome dataNarrative reviewVery low qualityRelated question
size not given2024
the abstract discusses the potential of these substances but reports no measured outcome or effect size
Who was studied
people with chronic wounds
What they received
manuka honey (and fish oil fatty acids) as topical treatment
Compared with
no comparator described
Main outcome
wound infection control and wound healing/closure
Quality
This is a narrative review discussing potential uses of manuka honey, not a study that tested it on patients, so it cannot show whether it actually works.
Limitations
No original patient data, no comparison group, and no mention of anorectal surgery; it is a review of general concepts about antimicrobial and wound-healing potential.
Taken word for word from the abstract
- population Chronic wounds are becoming an increasing burden on healthcare services
- intervention Manuka honey is already in some cases used as a topical treatment in the form of ointments
- comparator This review considers two prominent natural substances with established manufacturing and global distribution-marine based fatty acids (including their metabolites) and manuka honey
- primaryOutcome their function as antimicrobials and how they can aid in wound repair, two important aspects leading to resolution of chronic wounds
- result if the active components of the treatments were better understood, they could make valuable additions to topical treatment options
Microorganisms · PMID 39203434 · Read it on PubMed ↗
Suryadinata et al. 2024
Effect of honey and povidone-iodine on acute laceration wound healing: a pilot randomised controlled trial study
Honey healed as fast as alternatives.Randomised trialLow qualityRelated question
35 people2024
no statistically significant difference in healing time between honey, povidone-iodine, and paraffin groups, though honey had lower cost and fewer adverse events
Who was studied
patients with acute laceration wounds (cuts), mostly young adults, treated in Indonesia
What they received
honey as a wound dressing
Compared with
povidone-iodine or paraffin gauze dressing
Main outcome
time for the wound to heal
Quality
this is a small pilot trial with only about a dozen patients per group and no significant statistical difference found, so it cannot reliably show whether honey works better.
Limitations
small pilot study, single-blind, one patient lost to follow-up, and the honey type used was not specified as manuka honey; population was acute lacerations, not anorectal surgery wounds
Taken word for word from the abstract
- n A total of 35 patients (male to female ratio: 4:1), with a mean age of 22.5 (range: 6-47) years, were included
- population Acute laceration wound (ALW) is one of the most common injuries in Indonesia
- intervention honey group, n=12
- comparator povidone-iodine group, n=11; paraffin group, n=12
- primaryOutcome The outcomes were wound healing time, slow healing, secondary healing, signs of infection, wound dehiscence, oedema, maceration, necrosis, exudate and cost.
- result a median healing time of 10 (3-19) days for the honey group (p>0.05)
J Wound Care · PMID 39137253 · Read it on PubMed ↗
Tang et al. 2024
Efficacy and Safety of Honey Dressings in the Management of Chronic Wounds: An Updated Systematic Review and Meta-Analysis
Faster healing, but weak evidenceMeta-analysisVery low qualityRelated question
906 people2024
faster healing time and greater percentage healed with honey, but no significant difference in healing rate, bacteria clearance time, or hospital stay
Who was studied
people with chronic wounds
What they received
honey dressings
Compared with
standard wound care (as used in included studies)
Main outcome
wound healing time and percentage of wound healed
Quality
the authors themselves rate the evidence as very low quality due to risk of bias, inconsistent results across studies, and possible publication bias
Limitations
very low quality evidence due to risk of bias, inconsistency, and publication bias; studies are about chronic wounds in general, not specifically anorectal surgery or manuka honey
Taken word for word from the abstract
- n A total of eight studies, including 906 individuals that met the inclusion criteria, were incorporated.
- population the management of chronic wounds
- intervention honey dressings
- comparator evaluate the efficacy and safety of honey dressings in the management of chronic wounds
- primaryOutcome a significant acceleration in wound healing time with honey dressings (MD = -17.13, 95% CI -26.37 to -7.89, p = 0.0003) and an increase in the percentage of wound healing (MD = 18.31, 95% CI 8.86 to 27.76, p = 0.0001)
- result No statistically significant differences were observed in the healing rate (RR = 2.00, 95% CI 0.78 to 5.10, p = 0.15), clearance time of bacteria (MD = -11.36, 95% CI: -25.91 to 3.18, p = 0.13) and hospital stay duration.
- qualityWhy the quality of the evidence was very low due to the quality of risk of bias, inconsistency, and publication bias
Nutrients · PMID 39125335 · Read it on PubMed ↗
Map Schuh et al. 2024
A Natural deep eutectic solvent as an effective material for dual debridement and antibiofilm effects in chronic wound treatment
New material beat honey, not tested alone.Laboratory studyLow qualityRelated question
size not given2024
the new BU material reduced bacterial load and wound area more than honey did, in leg ulcers
Who was studied
people with leg ulcers, plus mice with diabetic wounds and lab/ex vivo skin samples
What they received
a new debriding material (BU) made from urea and betaine
Compared with
medical honey and an antiseptic (PHMB-Betaine)
Main outcome
ability to remove dead tissue, reduce bacterial/biofilm load, and shrink wound size
Quality
this is mainly a preclinical study (lab, ex vivo, and animal) with only a loosely described clinical portion, no patient numbers, and no mention of randomization or blinding.
Limitations
no participant numbers are given, the clinical evaluation is not described as randomized or controlled, and honey here is used only as a comparator to a different experimental material, not as the main treatment being tested.
Taken word for word from the abstract
- population evaluated in artificial slough and ex vivo human skin
- population BU was clinically evaluated in leg ulcers
- intervention a new debriding material (BU) suitable for application into injured dermal tissues
- comparator compared to the antiseptic PHMB-Betaine or medical honey
- primaryOutcome To evaluate BU's debriding capacity, along with its antibiofilm effect and biocompatibility
- result showing superiority in reduction of bacterial load and wound area compared to honey, with no adverse effects
Int J Pharm · PMID 39103063 · Read it on PubMed ↗
de la Mora-López et al. 2024
Production and performance evaluation of chitosan/collagen/honey nanofibrous membranes for wound dressing applications
Lab test: honey boosted antibacterial dressing performance.Laboratory studyVery low qualityRelated question
size not given2024
Honey improved antibacterial efficiency and the membranes were not toxic to skin cells
Who was studied
Laboratory test using bacterial cultures and human skin cells (fibroblasts and keratinocytes), not patients
What they received
Nanofiber wound dressing membranes made of chitosan, collagen and honey at different honey concentrations (5%, 10%, 15%)
Compared with
Membranes without honey (0% honey, PCH and PCHC)
Main outcome
Antibacterial effect against bacteria and biocompatibility (toxicity) with skin cells
Quality
This is a lab-only test on cells and bacteria in dishes, not on real wounds or patients, so it cannot show whether honey actually helps wounds heal in people.
Limitations
In vitro study only; no human or animal wound testing; honey type not specified as manuka; no participant numbers as this is not a clinical study
Taken word for word from the abstract
- intervention we formulate mixtures of polyvinyl alcohol (P), chitosan (CH), collagen (C), and honey (H) to produce nanofibrous membranes with healing properties
- comparator The honey effect at concentrations of 0 % (PCH and PCHC), 5 % (PCHC-5H), 10 % (PCHC-10H), and 15 % (PCHC-15H)
- primaryOutcome honey significantly improved the antibacterial efficiency of the nanofibers
- result honey significantly improved the antibacterial efficiency of the nanofibers, mainly PCHC-15H nanofibers, which presented the best bacterial reduction rates against Staphylococcus aureus (59.84 %), Pseudomonas aeruginosa (47.27 %), Escherichia coli (65.07 %), and Listeria monocytogenes (49.58 %)
- result nanofibers were not cytotoxic and exhibited excellent biocompatibility with human fibroblasts (HFb) and keratinocytes (HaCaT)
- population In vitro tests with cell cultures
Int J Biol Macromol · PMID 38996893 · Read it on PubMed ↗
Monami et al. 2024
Effectiveness of different advanced wound dressings versus standard of care for the management of diabetic foot ulcers: a meta-analysis of randomized controlled trials for the development of the Italian guidelines for the treatment of diabetic foot syndrome
Advanced dressings, honey included, sped healing a bit.Meta-analysisModerate qualityRelated question
size not given2024
Advanced dressings as a group had higher healing rates and shorter time to healing, though the healing-rate odds ratio itself was not statistically significant
Who was studied
people with diabetic foot ulcers
What they received
advanced wound dressings, including honey-impregnated dressings among other types
Compared with
standard of care or placebo dressings
Main outcome
rate of ulcer healing
Quality
The abstract itself rates the evidence for the main healing outcome as moderate, and the result for honey dressings specifically is lumped together with many other dressing types rather than reported alone.
Limitations
Honey-impregnated dressings were only one of many dressing types pooled together, so no honey-specific effect size is given; the main healing-rate result (OR 1.50 [0.80, 2.79], p=0.20) was not statistically significant despite being described as significant in the text.
Taken word for word from the abstract
- population collecting all RCTs including diabetic patients or reporting subgroup analyses on diabetic patients with DFU
- intervention AWD assessed were: alginates; foam, hydrocolloids, hydrogels, hyaluronic acid, hemoglobin spray, silver-impregnated, sucrose octasulfate-impregnated, honey-impregnated, micro-organism-binding, and protease-modulating matrix dressings.
- comparator comparing AWD with placebo/standard of care (SoC)
- primaryOutcome Prespecified endpoints were: ulcer healing (principal), time-to-healing, frequency of dressings change, major and minor amputation, pain, and all-cause mortality.
- result Participants treated with AWD had a significantly higher ulcer healing rate and shorter time-to-healing in comparison with SoC/placebo (MH-OR 1.50 [0.80, 2.79], p = 0.20 and WMD:: - 24.38 [- 42.90, - 5.86] days, p = 0.010).
- quality For the primary endpoint, the quality of evidence was rated as "moderate".
Acta Diabetol · PMID 38864979 · Read it on PubMed ↗
Nilawati Usman et al. 2023
Turmeric extract gel and honey in post-cesarean section wound healing: A preliminary study
Faster wound healing in rats with honey.Animal studyVery low qualityRelated question
56 people15 days
Trigona honey applied twice daily healed wounds fastest, by day 9, better than turmeric gel or control
Who was studied
Female white rats after cesarean section surgery
What they received
Trigona honey or turmeric extract gel applied to wound
Compared with
Control group (no treatment) and comparisons between honey/turmeric groups
Main outcome
Wound healing speed (redness, swelling, bruising, granulation tissue) measured by Reeda Scale
Quality
This is an animal study in rats, not humans, so it cannot reliably predict effects in people.
Limitations
Animal study in rats, not manuka honey specifically, and not anorectal surgery; small subgroups
Taken word for word from the abstract
- n The test animals were 56 female white rats
- population Female white rats ( Rattus novergicus) with pre- and post-testing and a control group were included in this experiment
- intervention application of 50% and 75% turmeric extract gel and Trigona honey
- comparator all three of these interventions were better than the control group
- primaryOutcome Wounds were assessed using the Reeda Scale
- result The fastest wound healing occurred in the group given Trigona honey twice daily. Redness, ecchymosis, and edema disappeared in this group on day 9 (score 0), and granulation tissue formed on day 9.
F1000Res · PMID 38817411 · Read it on PubMed ↗
Searan et al. 2026
The Influence of Honey and Hydrogel Products Therapy on Healing Time in Diabetic Foot
Faster healing with honey-hydrogel combo.Randomised trialLow qualityRelated question
120 people2026
combination of honey and hydrogel alternately healed fastest (10.83 days) versus honey alone (12.20), hydrogel alone (13.97), and fucidin (14.03 days), a significant difference
Who was studied
adults with type 2 diabetes and second-degree foot ulcers
What they received
honey alone, hydrogel alone, or honey and hydrogel used alternately
Compared with
fucidin ointment or cream
Main outcome
time for the wound to heal
Quality
small single-blinded trial in a different wound type (diabetic foot, not anorectal surgery) with only 30 patients per group.
Limitations
single-blinded design, small group sizes, population is diabetic foot ulcers not anorectal surgical wounds, honey type not specified as manuka
Taken word for word from the abstract
- n This study involved 120 patients
- population diabetic mellitus type 2 patients with ulcer in their second-degree feet
- intervention Cases were divided into 4 equal groups with altered treatment procedures: honey alone, hydrogel alone, honey, and hydrogel combination alternately (3 intervention groups)
- comparator fucidin ointment or cream alone (1 control group)
- primaryOutcome The mean healing time was about 12.76 ± 4.08 days.
- result the mean healing times for honey alone, hydrogel alone, and honey and hydrogel alternately were 12.20, 13.97, and 10.83 days, respectively. While it was 14.03 days in the control Fucidin ointment or cream [significantly P < .05 (P = 0.04)].
Int J Low Extrem Wounds · PMID 38425229 · Read it on PubMed ↗
Suryadinata et al. 2024
Honey dressing for penile skin avulsion caused by traditional circumcision: a case report
Wound fully healed in one patient.Case seriesVery low qualityRelated question
size not given43 days
wound fully re-healed by day 43 without becoming a chronic wound
Who was studied
24-year-old man with penile skin loss from traditional circumcision
What they received
honey dressing on the wound
Compared with
none described
Main outcome
complete wound healing (re-epithelialisation)
Quality
This is a single patient case report with no comparison group, so it cannot show whether honey caused the healing or whether another treatment would have done the same or better.
Limitations
Single case, no control group, wound type and setting (traditional circumcision injury) differ from anorectal surgery, honey brand not specified as manuka.
Taken word for word from the abstract
- population A 24-year-old male patient with penile bleeding presented to the emergency department after undergoing traditional circumcision.
- intervention Honey (Madu Nusantara, PT. Madu Nusantara, Indonesia) was used as dressing after copious irrigation using saline and povidone-iodine with bleeding control.
- comparator RESULTS: Honey dressing was shown to be effective for secondary wound healing of such a complicated and contaminated wound
- primaryOutcome A complete re-epithelialisation of the wound was achieved without progression to the hard-to-heal state by day 43.
- result A complete re-epithelialisation of the wound was achieved without progression to the hard-to-heal state by day 43.
J Wound Care · PMID 38197284 · Read it on PubMed ↗
Tavakoli et al. 2023
Keratin- and VEGF-Incorporated Honey-Based Sponge-Nanofiber Dressing: An Ideal Construct for Wound Healing
Faster wound healing in animals.Animal studyLow qualityRelated question
size not given2023
the wound healed faster when covered with the honey-based bilayer dressing compared to other groups
Who was studied
full-thickness wounds in an animal model
What they received
bilayer honey-based dressing with keratin and VEGF (PAAc-Hny/Hny-Kr-VEGF)
Compared with
other wound dressing groups
Main outcome
speed and quality of wound healing (blood vessel formation, collagen synthesis, epidermal regeneration)
Quality
this is a small preclinical animal/lab study, not a human clinical trial, so it offers limited evidence for people.
Limitations
no participant numbers reported, animal model only, no human data, no mention of anorectal surgery context
Taken word for word from the abstract
- population full-thickness wound healed faster when it was covered with PAAc-Hny/Hny-Kr-VEGF than in other groups
- intervention PAAc-Hny/Hny-Kr-VEGF
- comparator than in other groups
- primaryOutcome faster blood vessel formation, collagen synthetization, and epidermal layer generation were also confirmed
- result The in vivo animal model demonstrated that the full-thickness wound healed faster when it was covered with PAAc-Hny/Hny-Kr-VEGF than in other groups.
ACS Appl Mater Interfaces · PMID 37990423 · Read it on PubMed ↗
Hernández-Rodríguez et al. 2026
The Effect of Honey, Aloe Vera, and Hydrocolloid Dressing on the Healing Process of Murine Excisional Wounds
Aloe vera healed wounds better than honey in mice.Animal studyVery low qualityRelated question
size not given2026
aloe vera reduced wound diameter compared with honey and the control hydrocolloid group
Who was studied
mice with full-thickness skin wounds
What they received
honey dressing
Compared with
aloe vera and hydrocolloid dressing
Main outcome
wound diameter / healing
Quality
This is a small animal (mouse) experiment, not a human study, and it does not directly compare honey against a control in a way that lets us judge honey's own effect.
Limitations
Animal (mouse) model, not human anorectal surgery; abstract does not report numbers of animals or directly state honey vs control comparison
Taken word for word from the abstract
- population we performed full-thickness excisions of the skin, including the panniculus carnosus, in mice
- intervention We analyzed the efficacy of 2 natural products-honey and aloe vera-versus hydrocolloid (HC) dressings as a control group in healing full-thickness wounds
- comparator versus hydrocolloid (HC) dressings as a control group
- primaryOutcome We analyzed the efficacy of 2 natural products-honey and aloe vera-versus hydrocolloid (HC) dressings as a control group in healing full-thickness wounds
- result We found that aloe vera reduced the diameter of the wounds compared to honey (p < .001) and the control group (p < .001).
Int J Low Extrem Wounds · PMID 37964535 · Read it on PubMed ↗
Guedes et al. 2023
Antibiofilm activity of promethazine, deferiprone, and Manuka honey in an ex vivo wound model
Reduced bacteria in lab skin model.Laboratory studyVery low qualityRelated question
size not given2023
Manuka honey reduced biofilm biomass of Staph aureus and reduced bacterial counts in the ex vivo skin model, but effects varied by bacteria species
Who was studied
porcine skin wound model infected with bacteria (not human patients)
What they received
Manuka honey (along with promethazine and deferiprone) applied to bacterial biofilms
Compared with
untreated bacterial biofilms
Main outcome
reduction of bacterial biofilm (colony counts and biomass) on skin
Quality
This is a lab experiment on pig skin and bacteria, not a clinical trial in people with wounds, so it cannot show whether honey helps real patients heal.
Limitations
In vitro and ex vivo only, no living human or animal wound healing tested, authors state further studies needed to confirm effectiveness in vivo.
Taken word for word from the abstract
- population biofilms cultivated on porcine skin for evaluation of the compounds
- intervention Manuka honey against Staphylococcus aureus and Pseudomonas aeruginosa in vitro and ex vivo in a wound model on porcine skin
- comparator counting colony-forming units (CFUs) and confocal microscopy were performed on biofilms cultivated on porcine skin for evaluation of the compounds
- primaryOutcome The minimum inhibitory concentrations (MICs) and the effects of the compounds on biofilms were evaluated
- result Manuka honey had MICs of 10%-40%, MBECs of 20 to >40% and reduced the biomass of S. aureus biofilms only
- result the compounds reduced (P < .05) CFU counts for both bacterial species, altering the biofilm architecture
- limitations However, further studies are needed to characterize the mechanisms of action and their effectiveness on biofilms in vivo.
Lett Appl Microbiol · PMID 37791895 · Read it on PubMed ↗
McArdle et al. 2023
The impact of wound pH on the antibacterial properties of Medical Grade Honey when applied to bacterial isolates present in common foot and ankle wounds. An in vitro study
Honey killed bacteria in lab dish.Laboratory studyVery low qualityRelated question
size not given2023
honey reduced bacteria at all pH levels tested, with no clear link between pH and bacteria killed
Who was studied
bacteria commonly found in diabetic foot ulcers and post-surgical foot and ankle wounds
What they received
medical grade honey adjusted to different pH levels (6, 7, 8)
Compared with
control solution (TSB) at same pH levels
Main outcome
ability of honey to kill or reduce bacteria at different pH levels
Quality
this was a lab dish experiment on bacteria, not a study in real patients or wounds, so it cannot show whether honey actually helps wounds heal.
Limitations
in vitro study only; no human participants, no wound healing outcomes measured
Taken word for word from the abstract
- population Pseudomonas aeruginosa (NCTC10782), Escherichia coli, (NCTC10418), Staphylococcus aureus (NCTC10655) and Staphylococcus epidermidis (NCTC 5955)
- intervention MGH (Activon) was altered to pH 6, 7 and 8
- comparator transferred into each pH adjusted MGH and TSB solution and the positive and negative controls
- primaryOutcome investigate the use of medical grade honey (MGH) when altered to environments typically present in foot and ankle wounds
- result MGH adjusted to various pH values had the ability to reduce bacteria cell survival in all pH variations for all bacteria tested
- result No correlations were noted among the pH environments investigated and the colony counts
J Foot Ankle Res · PMID 37784205 · Read it on PubMed ↗
Pinthong et al. 2023
Development of Natural Active Agent-Containing Porous Hydrogel Sheets with High Water Content for Wound Dressings
Lab material test only, no patients.Laboratory studyVery low qualityRelated question
size not given2023
the honey-containing porous hydrogel absorbed and swelled with fluid better and had improved structure, but this was tested on materials, not on wounds or patients
Who was studied
not applicable (laboratory material testing, no patients)
What they received
porous hydrogel wound dressing containing manuka honey
Compared with
non-porous hydrogel without manuka honey (and different honey concentrations)
Main outcome
physical properties of the hydrogel such as swelling, absorption, structure, and cell toxicity
Quality
this was a laboratory test of hydrogel material properties, not a study of wound healing in people, so it cannot show whether manuka honey helps wounds heal.
Limitations
no patients, no wounds, no clinical outcome measured; only material and cell-cytotoxicity testing in the lab
Taken word for word from the abstract
- population porous hydrogel system suitable for medium to heavy-exudating wounds
- intervention Manuka honey (MH) was also incorporated at concentrations of 1 and 10% w/w
- comparator the non-porous hydrogel (NPH) swelled to ~2000%, while PH weight increased ~5000%
- primaryOutcome characterized for morphology via scanning electron microscopy, mechanical rheology, swelling using a gravimetric method, surface absorption, and cell cytotoxicity
- result Incorporating MH the enhanced gel appearance and mechanical properties, including smaller pores and linear swelling
Gels · PMID 37367130 · Read it on PubMed ↗
Onuoha et al. 2023
Effect of manuka honey socket dressing on postoperative sequelae and complications following third molar extraction: A randomized controlled study
Faster socket healing, fewer complications.Randomised trialModerate qualityRelated question
112 people7 days
fewer unhealed sockets and fewer complications with manuka honey at 7 days
Who was studied
patients having mandibular third molar (wisdom tooth) extraction
What they received
manuka honey placed in the extraction socket before closing the gum
Compared with
socket closed without manuka honey
Main outcome
healing of the extraction socket at 7 days
Quality
it was a randomized trial but single-center, not blinded, and measured only short-term healing at 7 days
Limitations
abstract does not mention blinding; study is in tooth extraction sockets, not anorectal surgery wounds
Taken word for word from the abstract
- n In total, 112 participants completed the study, with 56 participants per group.
- population mandibular third molar extraction sockets
- intervention Group A underwent intrasocket application of manuka honey, after which sockets were completely closed using the mucosal flap
- comparator participants in group B underwent mucosal flap closure of the socket without application of manuka honey
- primaryOutcome The primary outcome was healing of the extraction socket at 7 days postoperatively.
- result On the 7th day postoperatively, 26.8% of participants in group B had an unhealed extraction site, compared with 10.3% of participants in group A (p = 0.029).
J Craniomaxillofac Surg · PMID 37164834 · Read it on PubMed ↗
Yildiz Karadeniz et al. 2023
Use of honey in diabetic foot ulcer: Systematic review and meta-analysis
Honey sped up wound healing.Meta-analysisLow qualityRelated question
size not given2023
Honey reduced healing time, pain, and hospital stay, and increased granulation
Who was studied
people with diabetic foot ulcers
What they received
honey dressing on the wound
Compared with
standard wound care (implied, not stated explicitly)
Main outcome
wound healing time, pain, hospital stay, and granulation
Quality
The abstract gives no numbers of patients or studies, mixes different study designs, and gives no detail on bias or honey type, so it's hard to trust the strength of the result.
Limitations
Abstract does not report sample size, specific honey type, or risk of bias; mixes RCTs, quasi-experimental and cross-sectional designs.
Taken word for word from the abstract
- population effective intervention for diabetic foot wound management
- intervention honey dressing
- primaryOutcome wound recovery time and rate, incurred pain, hospital stay, and accelerates granulation in DFU wounds
- result honey used effectively reduces wound recovery time and rate, incurred pain, hospital stay, and accelerates granulation in DFU wounds
- comparator We analyzed an assortment of randomized controlled trial (RCT), quasi-experimental and cross-sectional studies.
J Tissue Viability · PMID 37032304 · Read it on PubMed ↗
Retracted by the journal — not counted
Li et al. 2023
Effect of honey dressing in the management of diabetic foot ulcers: A meta-analysis
Faster healing in diabetic foot ulcersMeta-analysisVery low qualityRelated question
882 people2023
honey dressing led to higher healing rates and faster healing than control
Who was studied
people with diabetic foot ulcers
What they received
honey dressing applied to the wound
Compared with
standard wound care (control)
Main outcome
wound healing rate and time to healing
Quality
This is a retracted publication pooling mostly small, low-quality studies, so its findings cannot be trusted.
Limitations
Abstract states most included studies had low sample sizes and urges caution interpreting results; publication is listed as retracted.
Taken word for word from the abstract
- n The picked studies contained 882 subjects with DFUs were in the picked studies' baseline, 424 of them were using HD, and 458 were using a control.
- population diabetic foot ulcer (DFU)
- intervention honey dressing (HD)
- comparator 458 were using a control
- primaryOutcome The HD applied to DFUs caused a significantly higher wound healing rate (OR, 2.06; 95% CI, 1.45-2.93, P < .001) and lower wound healing time (MD, -10.42; 95% CI, -16.27- -4.58, P < .001) compared with the control.
- result The HD applied to DFUs caused a significantly higher wound healing rate (OR, 2.06; 95% CI, 1.45-2.93, P < .001) and lower wound healing time (MD, -10.42; 95% CI, -16.27- -4.58, P < .001) compared with the control.
- limitations precautions should be taken when commerce with the consequences since most of the picked studies for this meta-analysis was with low sample sizes.
Int Wound J · PMID 36994798 · Read it on PubMed ↗
Hajmohammadi et al. 2023
Fighting postsurgical infection after myelomeningocele repair with medical honey (Medihoney): a case report
Infected wound healed with honey.Case seriesVery low qualityRelated question
1 people2 months
the infection healed completely after 2 months of honey treatment
Who was studied
newborn baby girl with infected surgical wound after spina bifida repair
What they received
medical honey dressing (Medihoney)
Compared with
previous standard wound care (wet gauze and Vaseline dressing, antibiotics)
Main outcome
healing of the infected surgical wound
Quality
this is a single patient case report with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
only one patient, no control group, and the wound is a neurosurgical infection site, not an anorectal surgery wound.
Taken word for word from the abstract
- population a 10-day female infant born at 37-week- and 6-day of gestational age with a birth weight of 3700 g and Apgar 5/8 by emergency cesarean section due to spina bifida cystica with myelomeningocele (MMC)
- intervention We started the treatment using Medihoney™, honey antibacterial wound dressing, on SSI once a day for 2 weeks, then once every other day for the next 6 weeks.
- comparator despite regularly receiving wet and Vaseline gauze dressing and intravenous antibiotic therapy
- primaryOutcome Her SSI was cured entirely after 2 months
- result Her SSI was cured entirely after 2 months, and she was discharged from our wound treatment team in satisfactory general condition.
- n This case was a 10-day female infant
Childs Nerv Syst · PMID 36959360 · Read it on PubMed ↗
Ouchi et al. 2023
Topical Intervention of Natural Products Applied in Patients with Pressure Injuries: A Scoping Review
Honey dressings reduced wound size.Systematic reviewLow qualityRelated question
size not given2023
Honey and Plantago major dressings significantly reduced wound size compared with control treatments
Who was studied
patients with pressure injuries (bedsores)
What they received
topical natural products such as honey and Plantago major dressings
Compared with
standard control wound treatment
Main outcome
wound healing or wound size reduction
Quality
This is a scoping review of only six small controlled trials on pressure injuries, not surgical wounds, so it can't strongly support use for anorectal surgery.
Limitations
Only six controlled trials were found, and the review notes limited controlled clinical trials addressing natural products and pressure injuries in the literature.
Taken word for word from the abstract
- population individuals with PIs
- intervention topical interventions of natural products applied to patients with PIs
- comparator individuals treated with topical natural products compared to a control treatment
- primaryOutcome outcomes with wound healing or wound reduction
- result Honey and Plantago major dressings were the topical interventions that significantly reduced wound size.
- n Only six studies were included in this scoping review.
Adv Skin Wound Care · PMID 36812084 · Read it on PubMed ↗
Mele 2023
Electrospinning of honey and propolis for wound care
Reviews honey dressing technology, no patient data.Narrative reviewVery low qualityRelated question
size not given2023
The abstract reviews existing literature and discusses dressing effectiveness but does not give a specific quantitative result
Who was studied
People with skin wounds or burns (general context, not a specific study group)
What they received
Honey (including manuka honey) and propolis incorporated into electrospun nanofibre wound dressings
Main outcome
How well these dressings fight bacteria and promote cell growth and tissue repair
Quality
This is a narrative review about developing dressing technology, not a clinical study measuring actual wound healing outcomes in patients.
Limitations
No original patient data, no defined population or comparator, and no quantified outcomes are reported; it summarizes lab-level dressing development literature.
Taken word for word from the abstract
- intervention polymeric nanofibres that can release honey and other bee products (like propolis) to promote wound healing
- population wounds and burns
- primaryOutcome the effectiveness of the resulting dressings to inhibit bacterial growth and stimulate cellular proliferation and tissue repair
- result the effectiveness of the resulting dressings to inhibit bacterial growth and stimulate cellular proliferation and tissue repair is discussed
Biotechnol Bioeng · PMID 36733220 · Read it on PubMed ↗
Ahmed et al. 2022
Honey dressing: a missed way for orthopaedic wound care
All wounds healed with honey.Case seriesLow qualityRelated question
50 people2022
All cases showed improvement with complete wound healing and full coverage of bone and tendons, with a few complications treated by further minor procedures
Who was studied
adults with orthopaedic wounds from open fractures, infected bone non-healing, or post-surgical infections
What they received
honey-soaked gauze dressing applied to the wound
Compared with
none reported (no comparison group)
Main outcome
wound healing
Quality
This was a small single-arm study with no comparison group, so it can't show whether honey worked better than standard care.
Limitations
No control or comparator group; single-arm prospective study; small sample size
Taken word for word from the abstract
- n This prospective study included 50 cases
- population The aetiologies were open fractures (34 cases; 68%), infected tibial non-unions (nine cases; 18%), and post-operative infections (seven cases; 14%)
- intervention a ribbon of gauze soaked with honey was applied to the wounds after thorough saline washing
- comparator Besides treating the primary cause, a ribbon of gauze soaked with honey was applied to the wounds
- primaryOutcome The purpose of this study was to evaluate the efficacy of using honey for care of orthopaedic-related wounds
- result All cases showed improvement in all parameters with complete wound healing and full coverage of bone and tendons.
Int Orthop · PMID 35971015 · Read it on PubMed ↗
Ribeiro et al. 2022
Hydrogel dressings for venous leg ulcers
No clear difference found versus honey.Systematic reviewVery low qualityRelated question
272 peoplefour weeks in three studies and two weeks in one study; one study followed to 12 weeks after four weeks of treatment
uncertain whether hydrogel differs from manuka honey or other dressings for healing, because evidence is very low certainty
Who was studied
adults with venous leg ulcers
What they received
hydrogel wound dressing
Compared with
gauze and saline, alginate dressing, manuka honey, or hydrocolloid dressing
Main outcome
complete wound healing and change in ulcer size
Quality
Only small single trials with high risk of bias and imprecise results for each comparison, including the manuka honey one.
Limitations
High risk of bias in all trials, small sample sizes, incomplete reporting of variance data, and short follow-up periods.
Taken word for word from the abstract
- population Venous leg ulcers are a chronic health problem
- intervention hydrogel wound dressings
- comparator The studies compared hydrogel dressings with the following: gauze and saline, alginate dressing, manuka honey and hydrocolloid.
- primaryOutcome To assess the effects of hydrogel wound dressings on the healing of venous leg ulcers
- result It is uncertain whether there is a difference in complete wound healing (RR 0.75, 95% CI 0.46 to 1.21; 1 trial, 108 participants) or incidence of wound infection (RR 2.00, 95% CI 0.81 to 4.94; 1 trial, 108 participants) between interventions because the certainty of the evidence is very low.
- n Overall, 272 participants were randomised, in sample sizes ranging from 20 to 156 participants.
Cochrane Database Syst Rev · PMID 35930364 · Read it on PubMed ↗
Lin et al. 2022
Honey combined with silver ion dressing in complicated chronic wound of the scalp: a case report
Chronic scalp wound finally healed.Case seriesVery low qualityRelated question
1 people10 months
wound fully healed after 6 months of honey plus silver dressing treatment, no recurrence after 10 months
Who was studied
13-year-old girl with a chronic non-healing scalp wound after brain surgery infection
What they received
honey combined with silver ion wound dressing
Compared with
no comparator, prior treatment with repeated dressing changes and debridement that had failed
Main outcome
wound healing
Quality
this is a single patient case report with no comparison group, so it cannot show whether honey caused the healing.
Limitations
single case report, no control group, different wound type (scalp) and different population than anorectal surgery wounds
Taken word for word from the abstract
- n a 13-year-old female patient with a chronic wound
- population a case of a 13-year-old female patient with a chronic wound caused by a scalp incision infection 3 months after two operations for craniotomy for arachnoid cyst resection and cystic lesion-cisterna magna drainage
- intervention combining honey with silver ion dressings
- comparator After repeated dressing changes and two debridement operations, the incision had still not healed during the following year.
- primaryOutcome The wound finally healed after 6 months of dressing changes by combining honey with silver ion dressings
- result the incision had not re-ruptured after 10 months of follow-up
Eur Rev Med Pharmacol Sci · PMID 35916823 · Read it on PubMed ↗
Naik et al. 2022
When time does not heal all wounds-the use of medical grade honey in wound healing: a case series
Hard-to-heal wounds healed faster.Case seriesVery low qualityRelated question
6 people2022
wounds started healing, infection was controlled, and pain, odour and exudate improved
Who was studied
patients with long-standing hard-to-heal wounds, many with other health problems and infected wounds
What they received
medical grade honey (L-Mesitran) applied to the wound, alone or alongside other treatment
Compared with
the patients' own previous ineffective treatments
Main outcome
wound healing, infection control and quality of life (pain, odour, exudate)
Quality
this is a small series of just six patients with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
no control group, only six cases, patients had differing wounds and comorbidities, and honey was sometimes combined with other therapy
Taken word for word from the abstract
- n we have described six cases of hard-to-heal wounds
- population Most of the patients had comorbidities, and the majority of the wounds were contaminated with (multiresistant) bacteria
- intervention All wounds were treated with L-Mesitran (MGH-based wound care products, Triticum Exploitatie BV, the Netherlands) either as monotherapy or as a complementary therapy.
- comparator previous treatments had been ineffective
- primaryOutcome we have described six cases of hard-to-heal wounds, and discussed the effects of MGH on infection, wound healing and factors influencing patient QoL (pain, odour and exudate)
- result Hard-to-heal wounds started healing, infection was controlled and QoL was strongly improved (malodour, exudate levels and pain swiftly decreased) after the application of the MGH.
J Wound Care · PMID 35797263 · Read it on PubMed ↗
Belal et al. 2022
Effects of bee honey on promotion of peripheral nerve regeneration in an experimental model of nerve crush injury
Helped nerve healing in rats.Animal studyLow qualityRelated question
40 people2022
honey-treated rats showed better nerve and muscle function and structure than untreated injured rats
Who was studied
rats with crushed sciatic nerve injury
What they received
bee honey given locally or injected into the abdomen
Compared with
injured rats given no honey treatment
Main outcome
recovery of nerve and muscle function and structure
Quality
this is a small animal study on nerve injury, not a human wound-healing trial, so it offers only weak, indirect evidence for the question.
Limitations
animal model of nerve crush injury, not human surgical wound healing; small group sizes typical of such experiments; no mention of blinding or randomization
Taken word for word from the abstract
- n forty Wistar rats were divided into four groups
- population Animals of the first group were operated without inducing any lesion to the nerve. The other three groups were subjected to induction of nerve crush injury.
- intervention Two groups of them were treated with honey solution locally and intraperitoneally respectively.
- comparator The other group served as injured nontreated group.
- primaryOutcome Physiological indicators and structural investigations demonstrated considerable amelioration of the function and structure of nerves and muscles
- result Physiological indicators and structural investigations demonstrated considerable amelioration of the function and structure of nerves and muscles in the two treated groups compared with the injured nontreated group.
Pak J Pharm Sci · PMID 35642400 · Read it on PubMed ↗
Zhang et al. 2022
Preparation of aloe polysaccharide/honey/PVA composite hydrogel: Antibacterial activity and promoting wound healing
Honey gel sped healing in lab testLaboratory studyVery low qualityRelated question
size not given2022
the hydrogel inhibited bacteria and yeast and sped up healing of infected wounds
Who was studied
infected full-thickness wounds in a lab model
What they received
a hydrogel combining aloe plant polysaccharide, honey, and PVA plastic
Main outcome
how well the hydrogel fights bacteria and heals infected wounds
Quality
this is early-stage lab testing of a multi-ingredient gel, not a clinical study in people, so it can't show whether honey itself helps real patients heal.
Limitations
no participant population, no comparator group described, honey type (e.g. manuka) not specified, and product combines honey with aloe and PVA rather than testing honey alone
Taken word for word from the abstract
- intervention AP/Honey@PVA hydrogel was prepared by cross-linking AP, honey, PVA with borax
- primaryOutcome The hydrogels showed significant inhibitory effect on Staphylococcus aureus, Escherichia coli and Candida albicans, as well as accelerated the healing of infected full-thickness wound.
- result The hydrogels showed significant inhibitory effect on Staphylococcus aureus, Escherichia coli and Candida albicans, as well as accelerated the healing of infected full-thickness wound.
- population accelerated the healing of infected full-thickness wound
Int J Biol Macromol · PMID 35568151 · Read it on PubMed ↗
Wahdini et al. 2022
The use of Indonesian randu honey for chronic wounds in a patient with uncontrolled type 2 diabetes mellitus: A case report
Chronic wound eventually healed with honey.Case seriesVery low qualityRelated question
1 people1.5 years
wound fully closed after 1.5 years of treatment
Who was studied
a man with uncontrolled type 2 diabetes and a severe chronic leg wound
What they received
Indonesian randu honey wound dressing combined with other wound care
Compared with
no comparator, single patient case
Main outcome
complete wound closure
Quality
this is a single patient case report, so it cannot show whether honey caused the healing or reliably works for others
Limitations
single case, no control group, uses Indonesian randu honey not manuka honey, not anorectal surgery setting
Taken word for word from the abstract
- n A 54-year-old man with uncontrolled T2DM came with an unrecovered wound.
- population A 54-year-old man with uncontrolled T2DM came with an unrecovered wound.
- intervention a combination of Indonesian randu honey dressing and VAC on the exposed wound before and after the debridement and STSG
- comparator CASE PRESENTATION
- primaryOutcome After 1.5 years, the wound was fully closed
- result After 1.5 years, the wound was fully closed, and he could walk with the help of a walking stick.
Int J Surg Case Rep · PMID 35561469 · Read it on PubMed ↗
Alasqah et al. 2022
Effect of honey dressing material on palatal wound healing after harvesting a free gingival graft: a prospective randomized case control study
Faster wound healing with honeyRandomised trialLow qualityRelated question
20 people4 week
the honey-dressed wounds healed significantly more by week 1 and week 4 than the undressed wounds
Who was studied
patients who had a gum graft taken from the roof of the mouth
What they received
Medihoney dressing applied to the wound
Compared with
no dressing applied
Main outcome
percentage of the donor site wound healed (width and length) over time
Quality
very small study of only 20 people with no dressing as the comparison instead of a sham dressing, so bias is likely and results may not generalize.
Limitations
abstract does not describe blinding, and the comparator was no dressing at all rather than a placebo dressing
Taken word for word from the abstract
- n a sample of 20 patients with 10 patients in each group
- population palatal wound healing after harvesting free gingival graft (FGG)
- intervention Medihoney dressing material was applied to the donor site in the test group
- comparator no dressing material was applied to the control group
- primaryOutcome the length and the width of the donor site was measured and recorded
- result At 4-week, the healing of donor site percentage was found to be 86% (in width) and 91% (in length) for test group vs. 14% (in width) and 9% (in length) for the control group, the difference being statistically significant (p=0.001).
Eur Rev Med Pharmacol Sci · PMID 35503610 · Read it on PubMed ↗
Pleeging et al. 2022
Revolutionizing non-conventional wound healing using honey by simultaneously targeting multiple molecular mechanisms
Honey may help wounds heal.Narrative reviewLow qualityRelated question
size not given2022
honey showed beneficial effects on healing, reduced inflammation, infection, and pain across various non-conventional applications
Who was studied
people with wounds, including non-conventional uses like post colon surgery, mucositis, and tooth extraction
What they received
honey applied in novel ways (subcutaneous, intra-socket, abdominal, oral)
Compared with
not specified
Main outcome
wound healing, infection prevention, inflammation, and pain
Quality
this is a narrative review discussing mechanisms and summarizing other studies rather than presenting new controlled data, so it can't prove honey works for anorectal surgery wounds specifically.
Limitations
abstract does not report study designs, sample sizes, or specific results of the studies it reviews; variation between honey types is noted
Taken word for word from the abstract
- intervention Non-conventional routes of honey application include subcutaneous, intra-socket, abdominal, and oral administration in novel indications, such as post colon surgery, mucositis, and tooth extraction.
- population novel indications, such as post colon surgery, mucositis, and tooth extraction
- primaryOutcome reducing inflammation and wound dehiscence, and inducing healing, epithelialization, and analgesic activity
- result Honey consistently demonstrates beneficial therapeutic activities in these novel applications, orchestrating antimicrobial and prophylactic activity, reducing inflammation and wound dehiscence, and inducing healing, epithelialization, and analgesic activity.
- comparator Honey is a valuable alternative to conventional antimicrobial and anti-inflammatory therapies
Drug Resist Updat · PMID 35427872 · Read it on PubMed ↗
Adekunle et al. 2023
Wound Healing Following Palatoplasty Using Either Honey or Warm Saline Mouth Bath for Postoperative Wound Care: A Randomized-Controlled Study
Faster early healing, but no difference by 4 weeksRandomised trialLow qualityRelated question
50 people4 weeks
more people healed completely by 2 weeks with honey than with saline, but by 4 weeks all wounds had healed in both groups
Who was studied
people having cleft palate surgery
What they received
honey drops in the mouth after surgery
Compared with
warm saline mouth rinse after surgery
Main outcome
complete healing (re-epithelisation) of the surgical wound in the mouth at 2 and 4 weeks
Quality
it was a randomized trial but small, from one hospital, used clinical observation rather than blinded assessment, and studied a different type of surgical wound than anorectal surgery.
Limitations
small sample size, single center, wound assessment was 'clinically observed' rather than objectively measured, and the honey type was not specified as manuka
Taken word for word from the abstract
- n Fifty participants were recruited into the study, 24 in the Test group and 26 in the Control group.
- population participants with non-syndromic cleft palate
- intervention The test group received oral honey drops for post-operative care for an initial period of two weeks post-surgery
- comparator the control group had regular oral toileting using a warm saline solution
- primaryOutcome The primary outcome was epithelisation of lateral palatal defect at 2- and 4-weeks post repair.
- result Complete epithelisation of the lateral palatal defect was clinically observed in 66.7% of the participants in the Test group at 2 weeks post-operation, while only 38.5% of participants in the Control group had clinically observed complete epithelisation at the same time point (β = 1.70, p = .035, 95% CI 1.122-26.533). At four weeks, all wounds had epithelised irrespective of the study group.
Cleft Palate Craniofac J · PMID 35261292 · Read it on PubMed ↗
Parizad et al. 2022
Treating surgical site infection by honey antibacterial wound dressing in a neonate: a case report
Wound fully healed after honey.Case seriesVery low qualityRelated question
1 people3 months
the infected wound fully healed after treatment with honey dressing
Who was studied
a newborn baby with an infected surgical wound after tumor removal surgery
What they received
honey-containing antibacterial wound dressing (Medihoney)
Compared with
previous treatment with saline dressings and antibiotics
Main outcome
wound healing
Quality
this is a single patient case report with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
single case report, no control group, infection also received antibiotics before honey treatment
Taken word for word from the abstract
- population This case was a boy aged 38 weeks and 4 days with a birthweight of 2100 g
- intervention antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month
- comparator routine normal saline dressings twice a day and intravenous antibiotic therapy
- primaryOutcome The infant's SSI was wholly healed after 3 months
- result The infant's SSI was wholly healed after 3 months, and he was discharged from the wound treatment team in good general condition
- n This case was a boy aged 38 weeks and 4 days
Br J Nurs · PMID 35220733 · Read it on PubMed ↗
Hu et al. 2022
Treatment of Pasteurella multocida infection with dressings containing honey and antibacterials: a case report
Wound healed with honey dressings.Case seriesVery low qualityRelated question
1 people2022
successfully treated and healed after switching to honey dressings with antibiotics
Who was studied
a woman with severe cellulitis and bone infection in her hand from a Pasteurella multocida infection, likely from a pet exposure
What they received
dressings containing honey plus antibiotics
Compared with
earlier conventional wound dressings combined with antibiotics
Main outcome
wound healing
Quality
this is a single patient case report with no control group, so it cannot show whether honey itself caused the improvement
Limitations
only one patient, no comparison group, and the infection and wound type differ from anorectal surgical wounds
Taken word for word from the abstract
- n treating a woman with severe cellulitis and osteomyelitis on her hand caused by Pasteurella multocida
- population a woman with severe cellulitis and osteomyelitis on her hand caused by Pasteurella multocida
- intervention honey-containing dressings and antibiotics
- comparator conservative treatment using conventional wound dressings combined with antibiotics
- primaryOutcome successfully treated with honey-containing dressings and antibiotics after failure to heal
- result she refused surgical intervention and was successfully treated with honey-containing dressings and antibiotics after failure to heal following conservative treatment using conventional wound dressings combined with antibiotics
J Wound Care · PMID 35199596 · Read it on PubMed ↗
Wadi 2022
In Vitro Antibacterial Activity of Different Honey Samples against Clinical Isolates
Honey killed bacteria in lab dish.Laboratory studyVery low qualityRelated question
32 people2022
Honey stopped growth of all tested bacteria, while bacteria were less sensitive to antibiotics
Who was studied
bacteria samples isolated from patients, not wound patients themselves
What they received
raw natural and commercial honey samples tested against bacteria
Compared with
antibiotics (amoxicillin, ciprofloxacin, cefotaxime, chloramphenicol, gentamicin, tetracycline)
Main outcome
ability to stop bacteria growing in a lab dish
Quality
This is a lab dish test of bacteria, not a study of people with wounds, so it cannot show whether honey heals wounds.
Limitations
In vitro testing only on clinical bacterial isolates; no wound healing or patient outcomes assessed; no anorectal surgery context.
Taken word for word from the abstract
- population 8 clinical isolates collected from patients, at private hospital from Sudan
- intervention Thirty-two honey samples (raw and commercial honey) collected from different global countries with different floral origins were tested in vitro for antibacterial activity against 8 clinical isolates
- comparator amoxicillin, ciprofloxacin, cefotaxime, chloramphenicol, gentamicin, and tetracycline
- primaryOutcome tested in vitro for antibacterial activity against 8 clinical isolates
- result All of the bacterial species studied were uniformly receptive to all raw and commercial tested honey samples; in contrast, the tested organisms showed low sensitivity to antibiotics.
- n Thirty-two honey samples (raw and commercial honey) collected from different global countries
Biomed Res Int · PMID 35097108 · Read it on PubMed ↗
Saputri et al. 2022
The application of honey in wound care of raw surface at spontaneous rupture submandibular abscess that extends to submental and right neck: A case report
Wound improved, but no proof honey helpedCase seriesVery low qualityRelated question
1 people10 days after necrotomy
improvement seen 10 days after necrotomy with no allergic reactions or secondary infections
Who was studied
67-year-old man with a ruptured submandibular abscess wound extending to the neck
What they received
wound dressing with Nusantara honey (local Indonesian honey, not manuka)
Compared with
no comparison group; before/after wound care
Main outcome
wound healing and infection improvement after necrotomy
Quality
this is a single patient case report with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
single case, no control group, different honey type (Nusantara not manuka), different wound cause (neck abscess, not anorectal surgery), combined with antibiotics and surgery so honey's specific effect cannot be isolated
Taken word for word from the abstract
- n A 67 years old male patient
- population A 67 years old male patient came with a ruptured submandibular abscess that extends to the submental and right neck.
- intervention wound care using Nusantara honey on the sixth day after surgery
- comparator wound care using Nusantara honey on the sixth day after surgery
- primaryOutcome An improvement was seen on the 10th day after necrotomy.
- result An improvement was seen on the 10th day after necrotomy.
- result There were no allergic reactions or secondary bacterial infections after using honey in this patient.
Int J Surg Case Rep · PMID 34968982 · Read it on PubMed ↗
Ionescu et al. 2021
Design, preparation and in vitro characterization of biomimetic and bioactive chitosan/polyethylene oxide based nanofibers as wound dressings
Lab material test, not a healing studyLaboratory studyVery low qualityRelated question
size not given2021
the propolis and calendula combination nanofiber performed best in lab tests; manuka honey was only one of several tested additives and not shown to be superior
Who was studied
not applicable (laboratory material testing, not human patients)
What they received
chitosan/polyethylene oxide nanofiber wound dressings with added manuka honey, propolis, calendula, insulin, or arginine
Compared with
different nanofiber formulations compared to each other (propolis+calendula version singled out as best)
Main outcome
physical, biodegradation, blood compatibility, toxicity, antioxidant and antimicrobial properties of the nanofiber material in the lab
Quality
this is early-stage lab testing of a material, not a study on actual wounds or patients, so it cannot show whether manuka honey helps healing in people
Limitations
purely in vitro/material characterization work with no animal or human wound data, and no patients or surgery involved at all
Taken word for word from the abstract
- population SEM morphology analysis revealed well-alignment, unidirectional arrays, with small diameters, no beads, and smooth surfaces for developed CS_PEO-ACs NFs.
- intervention Manuka honey (trophic and antimicrobial effects), propolis (antimicrobial effects), Calendula officinalis infusion (antioxidant effect, reepithelialization stimulating agent), insulin (trophic effect), and L-arginine (angiogenic effect) were selected as ACs.
- comparator The most suitable for wound healing applications seems to be CS_PEO@P_C which showed an improved hemolysis index (2.92 ± 0.16%), is non-toxic (cell viability degree more than 97%), and has also significant radical scavenging effect (DPPH inhibition more than 65%).
- primaryOutcome The developed NFs showed good biodegradability (NFs mats lost up to 60% of their initial weight in PBS), increased hemocompatibility (hemolytic index less than 4%), and a reduced cytotoxicity degree (cell viability degree more than 90%).
- result In addition, CS_PEO@P_C presents increased antimicrobial effects, more noticeably for Staphylococcus aureus strain, which is a key feature in preventing wound infection and delaying the healing process.
Int J Biol Macromol · PMID 34756969 · Read it on PubMed ↗
Muhrbeck et al. 2022
Efficacy of topical honey compared to systemic gentamicin for treatment of infected war wounds in a porcine model: A non-inferiority experimental pilot study
No benefit over antibiotic for wounds.Animal studyVery low qualityRelated question
50 peopleeight days
honey did not reduce bacteria or wound size, while gentamicin reduced wound size but not sustained bacteria reduction
Who was studied
infected wounds in pigs
What they received
Manuka honey applied to wound surface
Compared with
gentamicin given as muscle injection
Main outcome
bacterial count and wound size after treatment
Quality
This was a small pilot study in just two pigs, so it can't tell us much about effects in humans.
Limitations
Only two pigs used, animal model not human, short treatment duration of eight days
Taken word for word from the abstract
- population 50 standardized wounds on two pigs were infected with S. aureus
- intervention topically applied Manuka honey
- comparator intramuscular gentamicin
- primaryOutcome Treatment efficacy was evaluated with quantitative cultures, wound area measurements, histological, immunohistochemical assays, and inflammatory response.
- result Topically applied Manuka honey did not reduce bacterial count or wound area for the duration of treatment.
- result wound area was significantly reduced with intramuscular gentamicin at the end of treatment
- n 50 standardized wounds on two pigs
Injury · PMID 34756413 · Read it on PubMed ↗
Kapoor et al. 2021
Manuka honey: A promising wound dressing material for the chronic nonhealing discharging wounds: A retrospective study
Wounds healed well with honey.Case seriesVery low qualityRelated question
15 people4 weeks
wound depth decreased markedly and wounds fully healed over with skin by 4 weeks
Who was studied
patients with chronic nonhealing discharging wounds on the face/mouth area
What they received
manuka honey applied directly to the wound along with antibiotics
Compared with
none (no comparison group, wounds assessed before and after treatment)
Main outcome
change in wound depth and discharge over time
Quality
small retrospective study with no comparison group, so improvement cannot be separated from natural healing or other treatments given alongside honey.
Limitations
retrospective design with no control group, small sample size of 15 patients, and honey was given together with antibiotics making it hard to isolate its effect.
Taken word for word from the abstract
- n The study includes 15 patients (9 males and 6 females, mean age: 38.06, range: 20-50 years)
- population chronic nonhealing discharging extraoral wounds
- intervention manuka honey in conjunction with the antibiotic treatment was directly applied onto the surface of the wound
- comparator Assessment was done on the basis of discharge and depth of the wound before the procedure and weekly for 4 weeks.
- primaryOutcome Assessment was done on the basis of discharge and depth of the wound before the procedure and weekly for 4 weeks.
- result The average depth of wound as seen at 15 sites after a week was 5.72 mm, and decrease in the average depth of wound seen at the end of the 4th week was 0.88 mm with complete wound epithelization. This was found to be statistically significant (P = 0.0001).
Natl J Maxillofac Surg · PMID 34483582 · Read it on PubMed ↗
Repellin et al. 2021
The effects of a proprietary Manuka honey and essential oil hydrogel on the healing of acute full-thickness wounds in dogs
No real healing benefit shown.Animal studyLow qualityRelated question
10 people21 days
Epithelialization was slightly higher with honey gel at some time points but wound contraction and histology scores did not differ, and overall no evidence supported benefit
Who was studied
healthy adult female beagle dogs with surgically created wounds
What they received
Manuka honey and essential oil hydrogel dressing (HoneyCure)
Compared with
standard-of-care dressing
Main outcome
wound healing measured by contraction, epithelialization, and histology
Quality
Small animal study with only 10 dogs, not directly testing human surgical wounds.
Limitations
Small sample size of healthy purpose-bred dogs with small acute wounds, may not reflect clinical wounds in humans or anorectal surgery.
Taken word for word from the abstract
- population Purpose-bred, adult, female beagles (n = 10)
- intervention HoneyCure® (HOC)
- comparator standard-of-care (CON) dressings
- primaryOutcome percent contraction and percent epithelialization
- result Epithelialization was 11.7, 10.4, and 10.1 percentage points higher in HOC wounds compared to CON wounds at days 16, 18, and 21 respectively. Wound contraction and histological scores did not differ between groups.
- n Purpose-bred, adult, female beagles (n = 10)
- result This study did not provide evidence to support the application of HoneyCure® in small, acute wounds in healthy dogs.
Vet Surg · PMID 34468038 · Read it on PubMed ↗
Zhang et al. 2021
Comparison of topical honey and povidone iodine-based dressings for wound healing: a systematic review and meta-analysis
Honey healed wounds faster than iodine.Meta-analysisLow qualityRelated question
1,236 people2021
Honey dressings showed a medium-to-large improvement in healing time, hospital stay, and pain scores compared with povidone iodine dressings
Who was studied
people with wounds (mixed types, not specified as anorectal surgery)
What they received
honey-based wound dressings (type of honey not specified as manuka)
Compared with
povidone iodine-based wound dressings
Main outcome
time to wound healing, length of hospital stay, and pain score
Quality
It pools 12 different studies on wounds of unspecified types without stating the honey was manuka or that any involved anorectal surgery, so it may not reflect this specific question.
Limitations
The abstract does not specify the type of honey used, the types of wounds included, or give a risk-of-bias assessment of the included studies.
Taken word for word from the abstract
- n 12 manuscripts with a total of 1236 participants
- intervention honey and povidone iodine-based dressings
- comparator povidone iodine-based dressings
- primaryOutcome mean healing duration, mean hospital stay duration and visual analogue scale (VAS) score of pain
- result The honey-based dressings demonstrated a medium-to-large effect in reduction of mean healing duration (Hedge's g: -0.81), length of hospital stay (-3.1) and VAS score (-1.2) as compared with the povidone iodine-based dressings.
- population wound healing
J Wound Care · PMID 33856925 · Read it on PubMed ↗
Shankhdhar 2021
Diabetic Foot Amputation Prevention During COVID-19
Foot ulcer fully healed with honey dressing.Case seriesVery low qualityRelated question
1 people4 weeks
the wound fully healed within 4 weeks
Who was studied
man with a diabetic foot ulcer that became infected
What they received
medical-grade honey-based wound dressing plus antibiotics, guided remotely
Compared with
none
Main outcome
complete wound healing
Quality
this is a single patient case report with no comparison group, so it cannot show whether honey caused the healing.
Limitations
single case report, remote/telephone-guided care during lockdown, combined with antibiotics so honey's individual effect cannot be separated, and this is a diabetic foot ulcer not anorectal surgery wounds.
Taken word for word from the abstract
- population the treatment of a patient with a diabetic foot ulcer on his left foot was interrupted by the novel coronavirus 2019 pandemic lockdown in India
- intervention the author guided the patient to dress the wound at home using a medical-grade honey-based product
- comparator the author prescribed amoxicillin/clavulanic acid in combination with linezolid for 2 weeks
- primaryOutcome Healing (complete epithelialization) was achieved within 4 weeks.
- result Healing (complete epithelialization) was achieved within 4 weeks.
- n the treatment of a patient with a diabetic foot ulcer
Adv Skin Wound Care · PMID 33852467 · Read it on PubMed ↗
Felbaum et al. 2021
Manuka Honey: Feasibility and Safety in Postoperative Neurosurgical Wound Care
Seemed safe, benefit unclear, no control group.Case seriesVery low qualityRelated question
25 people2021
7 of 25 patients still needed operative debridement and long-term antibiotics; no patient-reported adverse events occurred
Who was studied
postoperative neurosurgical patients with nonhealing or at-risk wounds after cranial or spinal surgery
What they received
topical application of active Leptospermum manuka honey (ALH) gel or ointment once a day for 2 to 4 weeks
Compared with
no comparison group
Main outcome
whether wounds required operative debridement and whether the honey was safe to use
Quality
This is a small, uncontrolled case series from a single surgeon with no comparison group, so it cannot show whether the honey actually helped healing.
Limitations
Retrospective, single-surgeon, no control group, small sample size, and population is neurosurgical (cranial/spinal) rather than anorectal surgery patients.
Taken word for word from the abstract
- n Twenty-five postoperative patients (12 cranial, 13 spinal) were identified to be at high risk of operative debridement.
- population cranial and spinal operations between 2018 and 2020 was performed in patients with nonhealing wounds or wounds deemed "at risk"
- intervention An ALH gel or ointment was applied to these incisions once a day for 2 to 4 weeks.
- comparator A single-surgeon retrospective case series review
- primaryOutcome Seven (four cranial, three spinal) patients required operative debridement and treatment with long-term antibiotic therapy.
- result All 25 patients were prescribed a topical application of ALH, which was easily adopted without patient-related adverse events. Seven (four cranial, three spinal) patients required operative debridement and treatment with long-term antibiotic therapy.
Adv Skin Wound Care · PMID 33852461 · Read it on PubMed ↗
Mosteiro-Miguéns et al. 2021
Successful Treatment of a Venous Leg Ulcer With Manuka Honey: A Case Study
Stubborn leg ulcer healed with honey.Case seriesVery low qualityRelated question
1 people38 days
the main ulcer fully healed within 38 days of starting Manuka honey, and pain improved within 17 days
Who was studied
a 76-year-old man with multiple venous leg ulcers that had not healed with other treatments
What they received
Manuka honey applied to the wound along with compression therapy
Compared with
his own prior unsuccessful treatments (iodized cadexomer ointment, hydrodetersive fiber dressings, hydrocolloid meshes, compression therapy, antibiotics)
Main outcome
complete healing (epithelialization) of the wound and wound-related pain
Quality
this is a single patient case report with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
single patient, no control group, cannot rule out natural healing or effect of continued compression therapy
Taken word for word from the abstract
- population Mr S. was a 76-year-old man with multiple comorbid conditions and hypersensitivity to silver-based compounds, who developed 3 VLUs of his right lower extremity.
- intervention We then initiated treatment with Manuka honey and continued compression therapy.
- comparator He experienced 90 days of unsuccessful treatments using an iodized cadexomer ointment, hydrodetersive fiber dressings, hydrocolloid meshes, compression therapy, and antibiotic treatment without progression toward wound healing.
- primaryOutcome His primary VLU was completely epithelialized within 38 days, and an adjacent VLU also showed progression toward healing.
- result His primary VLU was completely epithelialized within 38 days, and an adjacent VLU also showed progression toward healing. Mr S. reported clinically relevant improvement in wound-related pain at 17 days.
- n Mr S. was a 76-year-old man
J Wound Ostomy Continence Nurs · PMID 33427815 · Read it on PubMed ↗
Nizet et al. 2020
[Use of honey dressings in wound healing]
Honey may help wounds heal.Narrative reviewVery low qualityRelated question
size not given2020
honey seems to be an effective therapeutic agent in wound healing
Who was studied
people with wounds
What they received
medical graded honey dressings
Compared with
not reported
Main outcome
wound healing
Quality
This is a narrative article describing properties of honey dressings, not a study with data, so it offers very weak evidence.
Limitations
Abstract does not report any study design, population size, or comparative data; it is descriptive of properties and prior literature.
Taken word for word from the abstract
- intervention Medical graded honey dressings were recently developed.
- result honey seems to be an effective therapeutic agent in wound healing
- primaryOutcome their use for wound healing
- population wide range of wounds
- comparator The present article describes properties of medical graded honey dressings and their use for wound healing.
Rev Med Liege · PMID 33331704 · Read it on PubMed ↗
Nwagu et al. 2020
Treatment of recalcitrant chronic leg ulcer in a known sickle cell anaemia patient using honey and fresh hbaa red cell concentrate in a Nigerian secondary healthcare facility
Leg ulcer healed with honey treatment.Case seriesVery low qualityRelated question
1 people4 months
wound fully closed after 4 months of treatment
Who was studied
young adult with sickle cell anemia and chronic leg ulcer
What they received
local honey wound dressing plus blood transfusion
Compared with
no comparator, single case
Main outcome
wound healing of chronic leg ulcer
Quality
This is a single patient case report with no comparison group, so it cannot show whether honey actually caused the improvement.
Limitations
Single case report, combined treatment with blood transfusion makes it impossible to isolate honey's effect, no control group.
Taken word for word from the abstract
- n EA was a 20-year-old university undergraduate
- population a known sickle cell anemia patient, which did not respond to the wound dressing methods
- intervention The wound was dressed with local honey, and anemia corrected with blood transfusion using concentrated red cells lacking the HbS trait.
- comparator We report a case of chronic leg ulcer
- primaryOutcome There was a progressive improvement in the healing of the ulcer with total closure after 4 months of treatment.
- result total closure after 4 months of treatment
Ann Afr Med · PMID 33243953 · Read it on PubMed ↗
Sankar et al. 2021
Use of Honey Versus Standard Care for Hospital-Acquired Pressure Injury in Critically Ill Children: A Multicenter Randomized Controlled Trial
Faster wound healing with honey.Randomised trialModerate qualityRelated question
99 people2021
Median healing time was 7 days with honey versus 9 days with standard care, a statistically significant difference
Who was studied
critically ill children aged 2 months to 17 years with pressure injury wounds in a pediatric ICU
What they received
medicated manuka (Leptospermum) honey dressing on the wound
Compared with
standard routine wound care
Main outcome
time to complete wound healing
Quality
It was a well-designed randomized trial but open-label, in a different population (hospitalized children with pressure sores, not anorectal surgery patients), limiting how directly it applies.
Limitations
Open-label design (not blinded), small sample size, and population differs from anorectal surgery wounds.
Taken word for word from the abstract
- n A total of 99 children were enrolled: 51 in the intervention group and 48 in the standard care group.
- population Critically ill children, 2 months to 17 years old, who developed pressure injury (stages 1-3) were included
- intervention Manuka or active Leptospermum honey dressing/gel was used in the intervention group.
- comparator Children were randomized to receive either medicated honey dressing or standard (routine) wound care
- primaryOutcome The primary outcome was the time to complete wound healing.
- result The median time to complete healing was 7 days (95% CI, 6-7 d) versus 9 days (7-10 d) in the intervention and standard care groups, respectively (p = 0.002; log-rank test).
Pediatr Crit Care Med · PMID 33181730 · Read it on PubMed ↗
Nolan et al. 2020
Clinical Significance of Manuka and Medical-Grade Honey for Antibiotic-Resistant Infections: A Systematic Review
Honey kills bacteria in lab tests.Systematic reviewLow qualityRelated question
size not given2020
all honeys tested strongly inhibited bacterial growth regardless of whether the bacteria were drug-resistant, with Surgihoney the most potent
Who was studied
bacteria samples including multidrug-resistant strains tested in laboratory studies, not patients
What they received
manuka and other medical-grade honeys applied directly to bacteria in lab experiments
Compared with
different types of honey compared against each other and against bacterial strains
Main outcome
how well honey stopped bacterial growth (minimum inhibitory concentration) in lab tests
Quality
This is a lab-based review of bacteria in dishes, not a study of wounds healing in actual patients.
Limitations
Abstract reports in-vitro antimicrobial susceptibility testing only; no patient wound-healing outcomes, no clinical trial data, no mention of anorectal surgery.
Taken word for word from the abstract
- population 32 different bacterial species, including numerous MDR strains
- intervention the effectiveness of differing honeys as an antimicrobial treatment against a variety of multidrug-resistant (MDR) bacterial species
- comparator 18 different types of honey against 32 different bacterial species
- primaryOutcome displaying minimum inhibitory concentrations as low as 0.1% (w/v)
- result all honeys reviewed showed a high efficacy against most bacterial species analysed
- result the MDR status of each bacterial strain had no impact on the susceptibility of the organism to honey
Antibiotics (Basel) · PMID 33142845 · Read it on PubMed ↗
Rodriguez et al. 2023
Preliminary Clinical Evaluation Using a Novel Bioengineered Wound Product to Treat Lower Extremity Ulcers
Faster healing in diabetic foot ulcers.Case seriesVery low qualityRelated question
12 people8 weeks
9 of 12 patients achieved 100% wound closure within 8 weeks, with mean closure time of 4.1 weeks and 94% mean closure at 4 weeks
Who was studied
patients with lower extremity ulcers, including diabetic foot ulcers
What they received
a bioengineered wound product made of gelatin, Manuka honey, and hydroxyapatite applied to the wound
Compared with
none - no control group, compared to patients' own prior standard of care
Main outcome
wound closure (healing of the ulcer)
Quality
This was a tiny uncontrolled case series of only 12 patients with no comparison group, so it cannot show whether the product itself caused the healing.
Limitations
No control group, very small sample (12 patients), described as a 'preliminary clinical evaluation'
Taken word for word from the abstract
- population 12 patients with lower extremity ulcers
- intervention a solid absorbable and conformable sheet composed of gelatin, Manuka honey, and hydroxyapatite
- comparator little to no progression of healing with standard of care or treatment with other biomaterials
- primaryOutcome evaluate lower extremity ulcers treated with a novel bioengineered wound product
- result These patients achieved 100% closure within 8 weeks, with a mean closure time of 4.1 weeks. At 4 weeks, the mean percent wound closure was 94%.
- n applied on 12 patients with lower extremity ulcers
- followUp achieved 100% closure within 8 weeks
Int J Low Extrem Wounds · PMID 33121306 · Read it on PubMed ↗
Frydman et al. 2020
Manuka honey microneedles for enhanced wound healing and the prevention and/or treatment of Methicillin-resistant Staphylococcus aureus (MRSA) surgical site infection
Lab study: honey microneedles killed MRSA, aided closure.Laboratory studyVery low qualityRelated question
size not given2020
Manuka honey microneedles killed MRSA bacteria and vacuum-prepared honey showed a trend toward faster wound closure than cooked honey
Who was studied
Laboratory cell/bacterial models, not human patients
What they received
Manuka honey microneedles (MHMs), synthesized using different methods including vacuum-treatment
Compared with
Cooked honey microneedles and different honey concentrations
Main outcome
Bacteria killing (MRSA) and speed of wound closure in lab assays
Quality
This is early lab testing on cells and bacteria, not a study in patients, so it can't show whether this helps real wounds heal.
Limitations
In vitro only; no human or animal wound-healing model tested; wound closure differences described only as a trend, not statistically confirmed in the abstract.
Taken word for word from the abstract
- population evaluated with in vitro assays
- intervention MHMs were synthesized using multiple methods and evaluated with in vitro assays
- comparator while the cooked honey had incomplete wound closure, the vacuum-treated honey trended towards faster wound closure
- primaryOutcome The wound-healing assay demonstrated that, at concentrations of 0.1%, while the cooked honey had incomplete wound closure, the vacuum-treated honey trended towards faster wound closure
- result MHMs demonstrated excellent bactericidal activity against MRSA at concentrations ≥ 10% of honey, with vacuum-prepared honey appearing to be the most bactericidal, killing bacterial concentrations as high as 8 × 107 CFU/mL
Sci Rep · PMID 32764604 · Read it on PubMed ↗
Schuhladen et al. 2021
Production of a novel poly(ɛ-caprolactone)-methylcellulose electrospun wound dressing by incorporating bioactive glass and Manuka honey
Lab material shows wound-healing potential.Laboratory studyVery low qualityRelated question
size not given2021
the honey/glass fiber mats supported wound closure in cell tests but antibacterial performance needs further optimization
Who was studied
human skin cells (dermal fibroblasts and keratinocyte-like cells) in lab tests
What they received
wound dressing fibers made of PCL-methylcellulose combined with Manuka honey and bioactive glass
Main outcome
wound closure support and antibacterial activity in lab tests
Quality
This is an early-stage lab material science study using cells, not patients, so it cannot show whether honey helps real wounds heal.
Limitations
No human or animal wound testing; only material characterization and cell culture experiments were performed.
Taken word for word from the abstract
- population cell biology tests using human dermal fibroblasts and human keratinocytes-like HaCaT cells
- intervention blend fiber mats were cross-linked using Manuka honey and additionally used as a biodegradable platform to deliver bioactive glass particles
- primaryOutcome ability to support wound closure influenced by the presence of bioactive glass
- result showed the potential of the fabricated composite fiber mats to be used as wound dressing, specially due to the ability to support wound closure influenced by the presence of bioactive glass
- result based on the results of the antibacterial tests, it is apparent that an optimization of the electrospun fiber mats is required to develop suitable wound dressing for the treatment of infected wounds
J Biomed Mater Res B Appl Biomater · PMID 32691500 · Read it on PubMed ↗
Smaropoulos et al. 2021
Medical-Grade Honey for the Treatment of Extravasation-Induced Injuries in Preterm Neonates: A Case Series
Wounds healed, no infections seen.Case seriesVery low qualityRelated question
7 people2021
all wounds healed and closed within 7 to 67 days, with no infections detected
Who was studied
premature newborn babies with IV fluid leakage injuries
What they received
medical-grade honey applied to wounds
Compared with
none (no comparison group)
Main outcome
wound healing and closure
Quality
this was a tiny uncontrolled case series with no comparison group, so it cannot show honey worked better than standard care.
Limitations
no control group, very small number of patients, different population (preterm neonates with IV injuries, not surgical anorectal wounds)
Taken word for word from the abstract
- population 7 preterm neonates (28-36 weeks of gestation) with extravasation injuries
- intervention treated with daily cleaning and application of MGH
- comparator Some of the cases needed additional surgical intervention or assisted debridement.
- primaryOutcome all extravasation injury wounds presented with granulation tissue formation progressed to normal epithelialization and closed
- result closed in 7 to 67 days (median: 32 days)
- result no signs of infection were detected, irrespective of initial wound presentations
- n We present a case series of 7 preterm neonates
Adv Neonatal Care · PMID 32675576 · Read it on PubMed ↗
McNamara et al. 2020
Traditional and advanced therapeutic modalities for wounds in the paediatric population: an evidence-based review
No manuka honey findings reportedNarrative reviewVery low qualityRelated question
size not given2020
the review discusses several treatments like amniotic membrane grafts, Helicoll, and negative pressure wound therapy, but does not report specific findings for manuka honey beyond listing it as a search term
Who was studied
children and newborns with non-healing wounds from various causes
What they received
various wound care treatments including dressings, topical remedies and skin substitutes
Quality
this is a broad narrative review that searched databases but did not systematically analyze or report results for manuka honey specifically, and the authors state high-tier evidence in children is scarce overall.
Limitations
abstract states 'high tier evidence in these populations is scarce' and that 'RCTs involving larger sample sizes are necessary'; manuka honey is only mentioned as a search term, not discussed with specific results
Taken word for word from the abstract
- population Children can have non-healing wounds due to a wide range of pathologies, including epidermolysis bullosa (EB), pilonidal disease and Stevens-Johnson syndrome
- intervention 'Apligraf', 'dermagraft', 'Manuka honey', 'antibiotic', 'timolol', and 'negative pressure wound therapy' (NPWT)
- result Amniotic membrane living skin equivalent is a cellular matrix that has been reportedly successful in treating paediatrics wounds and is currently under investigation in randomised clinical trials.
- limitations high tier evidence in these populations is scarce
- limitations RCTs involving larger sample sizes are necessary
J Wound Care · PMID 32530778 · Read it on PubMed ↗
Yilmaz et al. 2020
HONEY DRESSING IN WOUND TREATMENT: A SYSTEMATIC REVIEW
Faster wound healing with honey.Systematic reviewLow qualityRelated question
30 people2020
honey sped up healing, reduced inflammation, pain and infection, and was cost-effective
Who was studied
people with acute and chronic wounds
What they received
honey dressing
Compared with
other wound treatments (as reviewed in included trials)
Main outcome
wound healing outcomes
Quality
it pools varied randomized trials without detailing their size or risk of bias, and does not separate manuka honey or anorectal surgery specifically.
Limitations
Abstract does not report study quality assessment, specific wound types, honey types, or anorectal surgery context.
Taken word for word from the abstract
- population honey in acute and chronic wounds
- intervention The use of honey for wound treatment and care purposes
- comparator investigating the randomized controlled studies
- primaryOutcome evaluate the place of honey in wound treatment
- result provided rapid epithelization and wound contraction in wound healing, had anti-inflammatory and debridement effect, decreased the pain, ensured infection control, shortened the time of wound healing and was cost-effective
- n 30 publications which were obtained as a result of the scans in the databases
Complement Ther Med · PMID 32507418 · Read it on PubMed ↗
Sams-Dodd et al. 2020
Micropore Particle Technology Promotes Wound Healing, Whereas Polyhexamethylene Biguanide Causes Tissue Degeneration: A Case Report
Wound worsened despite honey treatment.Case seriesVery low qualityRelated question
size not given2020
the wound got worse during 5 weeks of Manuka honey treatment, then improved only after switching to a different dressing
Who was studied
a 72-year-old woman with a nontraumatic spinal cord injury and a large wound with underlying bone infection
What they received
Manuka honey applied to the wound
Compared with
later treatments with micropore particle technology and then polyhexamethylene biguanide
Main outcome
whether the wound healed or worsened
Quality
this is a single patient case report with no control group, so it cannot show whether Manuka honey generally helps or harms wounds.
Limitations
single case, no comparison group, wound had multiple complex factors (spinal cord injury, osteomyelitis, abscess) that could explain the lack of healing besides the honey itself.
Taken word for word from the abstract
- n A 72-year-old woman with a nontraumatic spinal cord injury
- population A 72-year-old woman with a nontraumatic spinal cord injury developed eschar on her lower right back.
- intervention The wound was initially treated for 5 weeks with Manuka honey but deteriorated further.
- comparator Treatment approach was changed to polyhexamethylene biguanide (PHMB)
- primaryOutcome the wound reduced 50% in volume
- result The wound was initially treated for 5 weeks with Manuka honey but deteriorated further.
Wounds · PMID 32335523 · Read it on PubMed ↗
Ullah et al. 2020
Manuka honey incorporated cellulose acetate nanofibrous mats: Fabrication and in vitro evaluation as a potential wound dressing
Lab material shows antibacterial, wound-healing potentialLaboratory studyVery low qualityRelated question
size not given2020
The honey-infused mats stopped bacterial growth, showed antioxidant activity, and were safe for cells in lab dish testing
Who was studied
Laboratory testing with mouse fibroblast cells (NIH 3T3), not human patients
What they received
Manuka honey combined with cellulose acetate made into nanofiber wound dressing mats
Compared with
Different amounts of manuka honey mixed into the cellulose acetate mats
Main outcome
Whether the manuka honey nanofiber mats fight bacteria, act as antioxidants, and are safe for cells in lab testing
Quality
This is early lab material testing in cell dishes, not a study of real wounds or patients, so it cannot show whether this actually helps people heal.
Limitations
In vitro testing only; no animal or human wound healing data reported; no anorectal surgery population studied
Taken word for word from the abstract
- intervention the fabrication of cellulose acetate (CA)-Manuka honey (MH) composite nanofibrous mats as a biocompatible and antimicrobial wound dressing
- comparator CA mats with different quantities of MH were developed by electrospinning
- primaryOutcome Inclusion of MH in the electrospun composite CA-MH nanofibrous mats shows high efficacy to prevent bacterial growth on the wound surface
- result The MH loaded CA nanofiber mats showed good antioxidant abilities
- result the mats show high cytocompatibility to NIH 3T3 cell line in in vitro testing, proving to be effective for promoting wound healing
- population the mats show high cytocompatibility to NIH 3T3 cell line in in vitro testing
Int J Biol Macromol · PMID 32240741 · Read it on PubMed ↗
Astrada et al. 2019
Successful treatment of a diabetic foot ulcer with exposed bone using Trigona honey: a case study
Diabetic foot ulcer fully healed.Case seriesVery low qualityRelated question
1 peopletwo months
the wound fully healed over with new skin after two months
Who was studied
a woman with a large infected diabetic foot ulcer with exposed bone
What they received
propolis-enriched Trigona honey dressing applied at home
Compared with
none (single treatment, no comparison group)
Main outcome
wound healing (re-epithelialisation)
Quality
this is a single patient case report with no control group, so it cannot show whether honey caused the healing.
Limitations
only one patient, no comparison group, and the honey used (Trigona) is not manuka honey.
Taken word for word from the abstract
- n a 38-year-old female patient
- population a 38-year-old female patient presenting with an extensive infected DFU with exposed bone
- intervention treated with propolis-enriched Trigona honey, used as a single treatment, in a home visit setting
- comparator used as a single treatment
- primaryOutcome the wound exhibited complete re-epithelialisation
- result After two months' follow-up, the wound exhibited complete re-epithelialisation despite the patient's initial poor condition.
J Wound Care · PMID 31825770 · Read it on PubMed ↗
Snelgrove et al. 2019
A review of interventions to reduce pain in chronic wounds
Honey dressing may reduce wound pain.Narrative reviewVery low qualityRelated question
size not given2019
a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain, and nitroglycerin ointment is especially effective
Who was studied
people with chronic wounds
What they received
honey dressing (among other wound care interventions)
Compared with
other wound dressings and treatments reviewed in the literature
Main outcome
reduction of chronic wound pain
Quality
this is a general literature review without stated systematic methods or numbers of patients, so it cannot reliably show whether honey helps wounds heal.
Limitations
The abstract does not describe study designs, sample sizes, or specific methods used to select or assess the included studies, and it covers wound pain generally rather than manuka honey or anorectal surgery specifically.
Taken word for word from the abstract
- population patients with chronic wounds
- intervention a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain
- comparator nitroglycerin ointment is especially effective
- primaryOutcome Reduction of chronic wound pain has the potential to improve patients' quality of life
- result a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain, and nitroglycerin ointment is especially effective
Br J Community Nurs · PMID 31804887 · Read it on PubMed ↗
Lu et al. 2019
Honey can inhibit and eliminate biofilms produced by Pseudomonas aeruginosa
Kills bacterial biofilms in lab testsLaboratory studyLow qualityRelated question
size not given2019
honey stopped biofilm formation, reduced established biofilms, and at clinical concentrations fully eliminated biofilms
Who was studied
Pseudomonas aeruginosa bacteria grown in lab biofilms (not human patients)
What they received
New Zealand honey (including manuka honey) applied to bacterial biofilms
Compared with
untreated biofilms / lower honey concentrations
Main outcome
ability of honey to prevent and kill bacterial biofilms
Quality
this is a lab dish experiment on bacteria, not a study of people with wounds, so it cannot show whether honey helps patients heal.
Limitations
abstract does not test honey on actual wounds or patients, only bacterial biofilms in the lab; does not address anorectal surgery
Taken word for word from the abstract
- population Bacterial biofilms cause most chronic wound infections
- intervention We assessed four well-characterised New Zealand honeys
- comparator honey used at substantially lower concentrations compared to those found in honey-based wound dressings
- primaryOutcome their capacity to prevent and eradicate biofilms produced by the common wound pathogen Pseudomonas aeruginosa
- result honey used at clinically obtainable concentrations completely eradicated established P. aeruginosa biofilms
Sci Rep · PMID 31796774 · Read it on PubMed ↗
Oryan et al. 2019
Application of honey as a protective material in maintaining the viability of adipose stem cells in burn wound healing: A histological, molecular and biochemical study
Better burn healing in rats.Animal studyLow qualityRelated question
size not given28 days
honey plus stem cell treatment improved angiogenesis, re-epithelialization, and granulation tissue formation compared to other treatments, with reduced inflammatory markers and increased growth factor expression
Who was studied
rats with burn wounds
What they received
honey combined with adipose stem cells (ASCs) under tegaderm dressing
Compared with
other treatment regimes
Main outcome
wound healing measured by inflammation markers, angiogenesis, re-epithelialization, and granulation tissue formation
Quality
This is an animal study on burn wounds, not human anorectal surgery, with no participant numbers reported and no human applicability shown.
Limitations
Animal model only; no sample size reported; studies burn wounds not anorectal surgery; combines honey with stem cells rather than honey alone.
Taken word for word from the abstract
- population a combination of honey (H) and ASCs was applied on burn wounds and the injured area was then covered by a tegaderm (T) dressing in a rat model
- intervention Treatment with ASCs-containing honey (T-H/ASC)
- comparator compared to other treatment regimes
- primaryOutcome Wound healing was evaluated by histopathological, histomorphometrical, molecular, scanning electron microscopy, and biochemical assessments on days 7, 14, and 28 post-wounding.
- result T-H/ASCs significantly improved angiogenesis, re-epithelialization, and granulation tissue formation compared to other treatment regimes, at 14 day post-surgery.
Tissue Cell · PMID 31759413 · Read it on PubMed ↗
Abu-Mostafa et al. 2019
The influence of intra-alveolar application of honey versus Chlorhexidine rinse on the incidence of Alveolar Osteitis following molar teeth extraction. A randomized clinical parallel trial
No benefit over chlorhexidine rinse.Randomised trialLow qualityRelated question
100 peopleday 3 and day 7
no significant difference in dry socket rates between honey and chlorhexidine, though honey group had slightly more pain, empty sockets, and dry socket cases
Who was studied
adults having a single molar tooth pulled
What they received
Manuka honey placed directly into the tooth socket after extraction
Compared with
chlorhexidine mouth rinse used twice daily for a week
Main outcome
development of dry socket (alveolar osteitis) after extraction
Quality
small trial with unequal group sizes and only one week of follow-up, so it can't reliably rule out a real difference
Limitations
unequal group sizes (43 vs 57), short follow-up of only 7 days, single trial
Taken word for word from the abstract
- population 100 patients who had a single molar tooth extraction
- intervention Manuka Honey applied topically by a cotton swab into the socket directly after extraction and on Day3
- comparator Group1 (G1) used 0.2 % CHX twice daily for 7 days
- primaryOutcome compare pain and AO after extraction of a molar tooth
- result Higher grades of pain, more empty sockets, and halitosis were found in G2 than in G1 on day3 and day7 without significant differences. Four cases of AO were found in G1 (9.3%) and 7 cases in G2 (12.3%), without significant difference between the two groups according to Chi-squared tests (p=0.753).
- n A randomized clinical trial of parallel groups was carried out on 100 patients who had a single molar tooth extraction.
J Clin Exp Dent · PMID 31636855 · Read it on PubMed ↗
Mokhtari et al. 2019
Evaluation of the effect of honey on the healing of tooth extraction wounds in 4- to 9-year-old children
Faster healing of tooth sockets.Randomised trialLow qualityRelated question
51 people7 days
wound sizes were significantly smaller in the honey group on both day 3 and day 7
Who was studied
children aged 4 to 9 years having a baby tooth pulled
What they received
honey applied to the tooth extraction wound
Compared with
saline solution applied to the wound
Main outcome
size of the wound at day 3 and day 7 after extraction
Quality
small randomized trial in a different setting (children's tooth extractions, not anorectal surgery) measuring only wound size, so it gives limited confidence for other wound types.
Limitations
small sample size; outcome limited to wound size measurement; different honey type and surgical site than anorectal surgery
Taken word for word from the abstract
- population 51 patients, 4‒9 years of age were selected randomly
- intervention the dentist used a cotton swab applicator to place a layer of honey on a piece of gauze moistened with normal saline solution (NSS) and placed it on the socket
- comparator In group 2, honey was not used; rather, NSS was applied
- primaryOutcome On days 3 and 7 after tooth extraction, the wound sizes were measured
- result On the third and seventh days after tooth extraction, wound sizes in the honey group were significantly lower than those in the NSS group (P < 0.05)
- n 51 patients, 4‒9 years of age were selected randomly
Niger J Clin Pract · PMID 31607720 · Read it on PubMed ↗
Sarraf et al. 2019
Effect of Honey on Healing Process of Extraction Socket in Rabbits
Faster healing in rabbit tooth sockets.Animal studyVery low qualityRelated question
6 people7th day
honey group had significantly more fibroblast proliferation and bony trabeculae formation than control, but no significant difference in inflammatory cells
Who was studied
rabbits with tooth extraction sockets
What they received
honey applied directly to the extraction site
Compared with
normal saline applied to the extraction site
Main outcome
healing of the tooth socket, measured by fibroblast growth, new bone formation and inflammation
Quality
this was a tiny animal study of only six rabbits looking at tooth sockets, not human anorectal wounds, so it tells us little about people.
Limitations
small number of animals (six), animal model rather than humans, different wound type (dental extraction socket) than anorectal surgery, honey type not specified as manuka
Taken word for word from the abstract
- population Extraction of first premolar tooth on both sides of lower jaw in six rabbits
- intervention local application of honey on one socket (honey group)
- comparator normal saline (control group) in the opposite socket
- primaryOutcome To evaluate the effect of honey on the healing process of socket after tooth extraction
- result There was a significant difference between control group and honey group in terms of fibroblast proliferation (p = 0.0019) and bony trabeculae formation (p=0.0003). Inflammatory cells were also observed in both groups and it was statistically not significant (p=1.0000).
- n six rabbits
- followUp On 7th day, biopsy was taken from the extraction site
Kathmandu Univ Med J (KUMJ) · PMID 33311037 · Read it on PubMed ↗
Sylvester-Hvid et al. 2019
Benign tumours leading to total penile denudation treated with Manuka honey dressings: A case report and review of literature
Penile wound healed with honey dressings.Case seriesVery low qualityRelated question
1 people2019
wound healed fully and sexual function returned
Who was studied
man with penile skin loss from tumours and infection
What they received
manuka honey dressings
Compared with
failed skin graft surgery, no other comparator
Main outcome
wound healing and recovery of function
Quality
this is a single patient case report so it cannot show whether honey works in general
Limitations
only one patient, not anorectal surgery, no control group, treatment used as salvage after failed graft
Taken word for word from the abstract
- n A 55-year-old non-smoking male
- population Penile denudation is a devastating condition
- intervention Manuka honey dressings was used
- comparator after failed STSG
- primaryOutcome Full sexual function was regained, and the patient was satisfied with the result.
- result We successfully treated a penile denudation with Manuka honey following a failed STSG.
Int J Surg Case Rep · PMID 31377541 · Read it on PubMed ↗
Boyar 2019
Topical Leptospermum Honey in the Management of Aplasia Cutis Congenita in Neonates: A Case Study
Wound closed fully with honey.Case seriesVery low qualityRelated question
1 people2019
The wound fully closed, with healing time similar to or faster than reported in other studies
Who was studied
a newborn baby with a large area of missing skin at birth (aplasia cutis congenita)
What they received
topical Leptospermum (manuka) honey applied twice daily under a dressing
Compared with
no control group; compared with previously published healing times
Main outcome
complete closure of the skin defect
Quality
This is a single case report with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
Only one patient, no control group, and a very different wound type (congenital skin defect) from anorectal surgical wounds.
Taken word for word from the abstract
- population a case of a full-term neonate with a large ACC lesion
- intervention applying topical ALH twice a day and covering defects with a secure dressing
- comparator Time to closure was either similar or shorter than published data.
- primaryOutcome All lesions progressed to complete closure.
- result All lesions progressed to complete closure. Time to closure was either similar or shorter than published data.
- n a case of a full-term neonate with a large ACC lesion
J Wound Ostomy Continence Nurs · PMID 31276452 · Read it on PubMed ↗
Shan 2019
Medicinal honey in clinical practice: viable alternative or useful adjunct in wound care management?
No strong evidence yet.Narrative reviewVery low qualityRelated question
size not given2019
no large-scale trials yet, but case studies suggest benefits for wound healing
Who was studied
people with wounds
What they received
medicinal honey, especially manuka honey
Main outcome
wound healing and antimicrobial effect
Quality
this is a narrative review based on in vitro studies and case reports, not controlled trials, so it can't reliably show whether honey works
Limitations
abstract states large-scale clinical trials are yet to be conducted and evidence is from in vitro studies and case studies
Taken word for word from the abstract
- intervention Among the plethora of complementary medicines now being considered is honey, particularly manuka honey.
- population especially in wound healing
- primaryOutcome effective antimicrobial agents in in vitro studies
- result Large-scale clinical trials are yet to be conducted but there is considerable interest and numerous case studies that demonstrate the benefits of medicinal honey, especially in wound healing.
Br J Nurs · PMID 31242111 · Read it on PubMed ↗
Tang et al. 2019
Honey loaded alginate/PVA nanofibrous membrane as potential bioactive wound dressing
Promising honey dressing material in lab tests.Laboratory studyVery low qualityRelated question
size not given2019
Honey-loaded membranes showed enhanced antioxidant activity, antibacterial activity against S. aureus and E. coli, and were non-cytotoxic and biocompatible
Who was studied
laboratory testing of a wound dressing material, not human patients
What they received
honey incorporated into an alginate/PVA electrospun nanofiber membrane
Compared with
nanofibrous membranes with varying honey content (compared to each other/no honey)
Main outcome
antioxidant activity, antibacterial activity, and cytotoxicity of the honey-loaded nanofiber membrane
Quality
This was a laboratory material-science study testing the dressing's chemical and antibacterial properties, not a clinical trial on actual wounds or patients.
Limitations
Purely in-vitro/lab characterization study; no animal or human wound healing data reported.
Taken word for word from the abstract
- intervention honey was incorporated into an alginate/PVA-based electrospun nanofibrous membrane to develop an efficient wound dressing material
- comparator The nanofibrous membranes with increasing honey content showed enhanced antioxidant activity
- primaryOutcome demonstrating that honey was successfully introduced to the nanofibers
- result The nanofibrous membranes with increasing honey content showed enhanced antioxidant activity, suggesting the ability to control the overproduction of reactive oxygen species. Disc diffusion assay and dynamic contact assay proved the antibacterial activity of the honey loaded nanofibers towards Gram-positive bacterium (Staphylococcus aureus) and Gram-negative bacterium (Escherichia coli). The cytotoxicity assay illustrated the non-cytotoxicity and biocompatibility of the nanofibrous membranes.
- population Disc diffusion assay and dynamic contact assay proved the antibacterial activity of the honey loaded nanofibers towards Gram-positive bacterium (Staphylococcus aureus) and Gram-negative bacterium (Escherichia coli).
Carbohydr Polym · PMID 31151507 · Read it on PubMed ↗
Hixon et al. 2019
Investigating Manuka Honey Antibacterial Properties When Incorporated into Cryogel, Hydrogel, and Electrospun Tissue Engineering Scaffolds
Lab test of honey-infused scaffolds, not healing.Laboratory studyVery low qualityRelated question
size not given2019
Electrospun scaffolds released Manuka honey faster and cleared more bacteria, while cryogels and hydrogels released it slower for longer-term effect
Who was studied
Lab experiment testing scaffolds with bacteria and cells, not patients or wounds
What they received
Manuka honey incorporated into cryogel, hydrogel, or electrospun tissue scaffolds
Compared with
Different scaffold geometries compared to each other
Main outcome
Bacterial clearance, bacterial adhesion, and cellular adhesion in lab testing
Quality
This is a laboratory materials experiment with no patients or wounds, so it cannot show whether honey helps wounds heal in people.
Limitations
Abstract does not report sample sizes or statistical testing, and this is an in-vitro study not involving human wounds or surgery.
Taken word for word from the abstract
- population MH was incorporated into cryogels, hydrogels, and electrospun scaffolds to assess the effect of scaffold geometry on bacterial clearance and adhesion, as well as cellular adhesion.
- intervention MH was incorporated into cryogels, hydrogels, and electrospun scaffolds
- comparator Overall, the fast MH release of the electrospun scaffolds versus the extended release of the HG and CG scaffolds provides differences in cellular/bacterial adhesion
- primaryOutcome to assess the effect of scaffold geometry on bacterial clearance and adhesion, as well as cellular adhesion
- result Electrospun scaffolds exhibited a faster release due to the nanoporous fibrous geometry which led to a larger partial bacterial clearance as compared to the more three-dimensional cryogels (CG) and hydrogels (HG).
Gels · PMID 31003516 · Read it on PubMed ↗
Zeleníková et al. 2019
Applying honey dressings to non-healing wounds in elderly persons receiving home care
Faster healing, less pain with honey.Randomised trialLow qualityRelated question
40 peoplethree months
80% of honey-treated wounds fully healed vs 30% of controls, with significantly smaller wound size and less pain in the honey group after 90 days
Who was studied
elderly home care patients over 65 with non-healing wounds
What they received
honey dressings
Compared with
conventional wound dressings
Main outcome
wound healing (size, complete healing) and pain intensity over 3 months
Quality
small study of only 40 people with no mention of blinding, so results could be due to chance or bias.
Limitations
Small sample size; no mention of blinding; honey type not specified as manuka; population is general non-healing wounds in elderly home care, not anorectal surgery patients.
Taken word for word from the abstract
- n The sample comprised 40 Czech home care clients
- population elderly persons receiving home care
- intervention Wounds were treated with honey (intervention group)
- comparator conventional (controls) dressings
- primaryOutcome Wounds were assessed with the Wound Healing Continuum and pain intensity with the Visual Analog Scale
- result 16 (80%) individuals in the intervention group had their wounds completely healed, as compared with only six (30%) controls
- result the difference in wound size between the groups was statistically significant (p = 0.0041)
- result higher pain scores being indicated by controls
J Tissue Viability · PMID 31000336 · Read it on PubMed ↗
Henry et al. 2019
Properties and use of a honey dressing and gel in wound management
Case reports only, no proof shown.Case seriesVery low qualityRelated question
4 people2019
the abstract describes case studies illustrating the dressing's attributes without giving a quantified outcome
Who was studied
patients with various types of wounds
What they received
a medical-grade honey dressing and gel (Revamil)
Compared with
no comparator reported
Main outcome
wound management outcomes such as healing, infection and debridement
Quality
This is a small set of four case reports with no control group, so it cannot show whether honey caused any improvement.
Limitations
No comparator group, only four case studies, and the honey type is not manuka-specific nor related to anorectal surgery.
Taken word for word from the abstract
- n four case studies
- population practitioners regularly encounter a wide variety of wound types
- intervention Revamil is a recent addition to the range of honey dressings available
- comparator The attributes of Revamil will be illustrated through four case studies.
- primaryOutcome promote autolytic debridement, deodorise wounds and promote granulation tissue
- result The attributes of Revamil will be illustrated through four case studies.
Br J Nurs · PMID 30925246 · Read it on PubMed ↗
Al-Khanati et al. 2019
Effect of Intrasocket Application of Manuka Honey on Postsurgical Pain of Impacted Mandibular Third Molars Surgery: Split-Mouth Randomized Controlled Trial
Less pain after tooth extraction.Randomised trialLow qualityRelated question
33 people7 days
pain scores were lower with honey on the first and second days after surgery, and patients needed less pain medicine
Who was studied
patients having impacted lower wisdom teeth removed on both sides
What they received
Manuka honey placed in the tooth socket before stitching
Compared with
no honey applied (nothing placed in the socket)
Main outcome
pain intensity after surgery measured on a visual pain scale
Quality
it is a small randomized study of only 33 people measuring pain for a few days, which is a different situation from wound healing after anorectal surgery
Limitations
Abstract does not describe blinding of pain assessment, and the surgery and body site are very different from anorectal wounds.
Taken word for word from the abstract
- population patients undergoing impacted bilateral lower third molars surgery under local anesthesia
- n This randomized split-mouth controlled study included 33 patients
- intervention Manuka honey applied just before suturing
- comparator other side to control group (nothing applied)
- primaryOutcome Postsurgical pain was evaluated using visual analogue scale (VAS) of faces 7 days after extraction
- result postoperative VAS scores were significantly lower compared to that in control group regarding first and second days postoperatively (P < 0.05). Total analgesic intake in the control group was significantly higher (P = 0.0001).
J Maxillofac Oral Surg · PMID 30728706 · Read it on PubMed ↗
Wang et al. 2019
Effectiveness of honey dressing in the treatment of diabetic foot ulcers: A systematic review and meta-analysis
Faster healing of diabetic foot ulcers.Meta-analysisLow qualityRelated question
size not given2019
honey dressing shortened debridement, healing and bacterial clearance times and increased healing and bacterial clearance rates in the first one to two weeks
Who was studied
people with diabetic foot ulcers
What they received
honey dressing applied to the wound
Compared with
other wound dressings
Main outcome
wound debridement time, wound healing time, bacterial clearance time and rates
Quality
it pools randomized and non-randomized studies without reporting participant numbers or study quality details, so the strength of the evidence is hard to judge.
Limitations
abstract does not specify number of studies or participants, types of honey used, or risk of bias; studies were a mix of RCTs and quasi-experimental designs.
Taken word for word from the abstract
- population treatment of diabetic foot ulcers (DFUs)
- intervention Honey dressing has been applied in the treatment of diabetic foot ulcers (DFUs)
- comparator honey dressing is more effective in the treatment of DFUs than other dressings
- primaryOutcome shortened the wound debridement time, wound healing time, and bacterial clearance time
- result it increased the wound healing rate and bacterial clearance rate during the first one to two weeks of use
Complement Ther Clin Pract · PMID 30712715 · Read it on PubMed ↗
Bayron et al. 2019
Medical-grade Honey as an Alternative to Surgery: A Case Series
Wounds healed without surgery.Case seriesVery low qualityRelated question
12 people2019
all 12 patients healed or improved using honey instead of surgery, without hospital readmission
Who was studied
patients with complex wounds who declined surgery
What they received
medical-grade Leptospermum (manuka) honey applied to wounds
Compared with
no comparator (alternative to surgical debridement or skin grafting)
Main outcome
wound healing without surgery
Quality
this is a small uncontrolled case series with no comparison group, so it cannot reliably show the honey caused the improvement
Limitations
no control group, small number of patients, selected from clinical experience and chart review rather than a controlled trial
Taken word for word from the abstract
- n Twelve patients with complex wounds were identified and included in this case series.
- population patients had to decline the recommendation of operative debridement or skin grafting
- intervention medical-grade honey (active Leptospermum honey [ALH]) as an alternative to surgery
- comparator as an alternative to surgery
- primaryOutcome facilitated autolytic debridement and healing without surgery or hospital readmission
- result The use of ALH facilitated autolytic debridement and healing without surgery or hospital readmission.
Wounds · PMID 30694209 · Read it on PubMed ↗
Karinja et al. 2018
Treatment of Infected Wounds in the Age of Antimicrobial Resistance: Contemporary Alternative Therapeutic Options
No specific results reported.Narrative reviewVery low qualityRelated question
size not given2018
the abstract lists honey as one of several promising alternative therapies but does not report any specific outcome or data for it
Who was studied
people with infected wounds, in context of rising antibiotic resistance
What they received
alternative non-antibiotic wound therapies, including honey
Quality
this is a narrative review describing a category of treatments without reporting specific study results, patient numbers, or outcomes for honey.
Limitations
abstract does not describe methodology, does not focus specifically on manuka honey or anorectal surgery, and reports no concrete findings for honey
Taken word for word from the abstract
- intervention with a focus on preclinical and human studies of therapeutic bacteriophages, antimicrobial peptides, cold plasma treatment, photodynamic therapy, honey, silver, and bioelectric dressings
- population As antibiotic resistance increases and antimicrobial options diminish, there is a pressing need to identify and develop new and/or alternative (non-antimicrobial-based) wound therapies
- result review the most promising non-antibiotic-based antimicrobial agents currently in research and development
Plast Reconstr Surg · PMID 30252823 · Read it on PubMed ↗
Singh et al. 2018
Scar free healing mediated by the release of aloe vera and manuka honey from dextran bionanocomposite wound dressings
Faster, scar-free healing in mice (lab study).Animal studyVery low qualityRelated question
size not given14th post wounding day
Mice treated with the aloe-vera-loaded dressing showed better skin healing (new skin growth) and complete wound closure by day 14, with orderly collagen formation and a thin top skin layer; the dressings also killed over 99% of two types of bacteria in lab tests
Who was studied
Mice with experimentally created wounds
What they received
Wound dressing made from a dextran-based nanocomposite material containing aloe vera and manuka honey
Compared with
Not clearly reported — base dressing material without aloe vera/manuka honey is implied but not explicitly compared for healing
Main outcome
Wound healing, scar prevention and skin appearance after treatment
Quality
This is a small lab/animal study with no reported sample size, no statistics, and the healing benefit described is specifically credited to aloe vera rather than clearly isolating manuka honey's effect.
Limitations
Animal (mouse) model only, no human data; sample size not reported; the healing result highlighted is for the aloe-vera dressing, not clearly separated from the manuka honey dressing's effect; no statistical comparison reported.
Taken word for word from the abstract
- population Wound healing analysis conducted in-vivo showed enhanced epithelialization in the terms scar prevention and aesthetics with absolute wound contraction for the mice treated with AV loaded dressings after 14th post wounding day.
- intervention we synthesized in-situ crosslinked dextran/nanosoy/glycerol/chitosan (DNG/Ch) nanocomposite membranes via solvent casting technique followed by subsequent addition of AV and MH to obtain DNG/Ch/AV and DNG/Ch/MH herbal dressings.
- comparator we synthesized in-situ crosslinked dextran/nanosoy/glycerol/chitosan (DNG/Ch) nanocomposite membranes via solvent casting technique followed by subsequent addition of AV and MH to obtain DNG/Ch/AV and DNG/Ch/MH herbal dressings.
- primaryOutcome Wound healing analysis conducted in-vivo showed enhanced epithelialization in the terms scar prevention and aesthetics with absolute wound contraction for the mice treated with AV loaded dressings after 14th post wounding day.
- result Wound healing analysis conducted in-vivo showed enhanced epithelialization in the terms scar prevention and aesthetics with absolute wound contraction for the mice treated with AV loaded dressings after 14th post wounding day.
- result Antibacterial studies confirmed >99% antibacterial activity against both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli)
Int J Biol Macromol · PMID 30248422 · Read it on PubMed ↗
Negut et al. 2018
Treatment Strategies for Infected Wounds
Review mentions honey, no clear result.Narrative reviewVery low qualityRelated question
size not given2018
the abstract does not report specific quantitative findings on Manuka honey's effect, only that it shows encouraging antibacterial activity
Who was studied
people with infected skin wounds
What they received
wound dressings containing natural antimicrobial agents, including Manuka honey
Main outcome
reducing wound bacterial infection and improving healing
Quality
this is a narrative overview of many treatments rather than a study testing Manuka honey itself, so it cannot show whether it actually works.
Limitations
The abstract is a general review covering many antimicrobial wound treatments (antibiotics, essential oils, honey, nanoparticles) without presenting original data, patient numbers, or direct comparisons for Manuka honey specifically; no anorectal surgery context is mentioned.
Taken word for word from the abstract
- population The treatment of skin wounds is a key research domain
- intervention wound dressings impregnated with honey, with a special emphasis on Manuka honey
- primaryOutcome to reduce wound bacterial colonization and infection, in order to improve the healing process
- result another natural product that exhibits encouraging antibacterial activity is honey
Molecules · PMID 30231567 · Read it on PubMed ↗
Costeloe et al. 2018
The use of honey in cochlear implant associated wounds in pediatric patients
Healed cochlear implant skin ulcers.Case seriesVery low qualityRelated question
3 people2018
all three patients' wounds fully healed without needing surgical repair
Who was studied
children with skin wounds/ulcers near cochlear implants
What they received
medical grade honey gel (TheraHoney) added to antibiotic treatment
Compared with
standard antibiotic treatment alone (before honey added)
Main outcome
complete wound closure without surgery
Quality
Only three patients with no comparison group, so it's hard to know if honey caused the healing.
Limitations
Very small retrospective case series of only 3 patients, no control group, different wound type (cochlear implant skin ulcers, not anorectal surgical wounds).
Taken word for word from the abstract
- n Three cases of wounds treated traditionally with antibiotics, plus the addition of TheraHoney, were retrospectively reviewed.
- population cutaneous infection and ulceration associated with cochlear implants
- intervention We present our experience using TheraHoney gel, a medical grade honey, for the successful treatment of cochlear implant associated skin breakdown.
- comparator Three cases of wounds treated traditionally with antibiotics, plus the addition of TheraHoney, were retrospectively reviewed.
- primaryOutcome complete wound closure was achieved at all three patients without the need for surgical reconstruction
- result With the addition of TheraHoney gel, complete wound closure was achieved at all three patients without the need for surgical reconstruction.
Int J Pediatr Otorhinolaryngol · PMID 29958620 · Read it on PubMed ↗
Szweda et al. 2018
Comparison of antimicrobial activity of selected, commercially available wound dressing materials
Mixed antibacterial results in lab test only.Laboratory studyVery low qualityRelated question
size not given2018
Manuka honey dressing showed high antibacterial activity in one lab test (disc diffusion) but this wasn't confirmed in the other test (time-killing assay); silver and povidone-iodine dressings performed better overall
Who was studied
bacteria samples in laboratory testing (not patients)
What they received
wound dressing containing manuka honey (Algivon)
Compared with
other wound dressings containing silver, chlorhexidine acetate, or povidone-iodine
Main outcome
ability to kill or inhibit bacteria
Quality
This is a lab test on bacteria in dishes, not a study on patients or wounds healing.
Limitations
In-vitro testing only against reference bacterial strains, not tested in actual wounds or patients, no healing outcomes measured.
Taken word for word from the abstract
- population four reference strains of bacteria: Staphylococcus aureus (PCM 2051), Staphylococcus epidermidis (PCM 2118), Pseudomonas aeruginosa (ATCC 27853), and Escherichia coli (K12)
- intervention Algivon, which contains manuka honey
- comparator silver, chlorhexidine acetate, povidone-iodine, and manuka honey
- primaryOutcome examine the antimicrobial potential of eight selected, commercially available wound dressings
- result High activity against all tested bacteria, but only in the disc diffusion assay, was observed for Algivon, which contains manuka honey.
J Wound Care · PMID 29738292 · Read it on PubMed ↗
Escárcega-Galaz et al. 2018
Mechanical, structural and physical aspects of chitosan-based films as antimicrobial dressings
Lab material test, not clinical healing.Laboratory studyVery low qualityRelated question
size not given2018
Films with honey showed increased antimicrobial contact area (to 44%) and improved elongation, but antimicrobial effect occurred only by direct contact
Who was studied
Not patients; laboratory testing of chitosan-based film material against bacteria
What they received
Chitosan films formulated with a glycerol-honey mixture
Compared with
Pure chitosan films without honey
Main outcome
Mechanical, physical, and antimicrobial properties of the film material
Quality
This is a laboratory materials study testing film properties against bacteria in a dish, not a clinical study of wound healing in patients.
Limitations
No human or animal wound healing was tested; honey type not specified as manuka; no clinical outcomes reported.
Taken word for word from the abstract
- intervention films formulated with a glycerol-honey mixture were characterized
- comparator films of pure chitosan
- primaryOutcome the mechanical, physical, and microbiological properties films
- result the films were found to have an effect only by direct contact. In the films formulated with honey, the area of contact increased to 44%
- population evaluating the antimicrobial activity of the films against Pseudomonas aeruginosa and Klebsiella pneumoniae
Int J Biol Macromol · PMID 29727650 · Read it on PubMed ↗
Giusto et al. 2018
Pectin-honey hydrogel: Characterization, antimicrobial activity and biocompatibility
Material shown safe, not tested for healing.Laboratory studyVery low qualityRelated question
size not given2018
the hydrogel was non-toxic to fibroblasts, showed antibacterial activity against bacteria, and caused no harmful inflammatory or tissue changes in rats
Who was studied
cultured fibroblast cells and rats (not human patients)
What they received
a pectin-honey hydrogel wound dressing
Compared with
no comparator treatment described
Main outcome
material properties including antibacterial activity, biocompatibility and tissue tolerance
Quality
this is an early-stage lab and animal material-testing study with no comparator and no human wound-healing outcome measured.
Limitations
no human patients, no wound-healing outcome measured, no comparison group, and the number of animals used is not reported.
Taken word for word from the abstract
- population cultured fibroblast cells and by in vivo study with subcutaneous and intraperitoneal implantation in rats
- intervention Novel pectin-honey hydrogels have been developed and characterized as medical device
- comparator BACKGROUND: Novel pectin-honey hydrogels have been developed and characterized as medical device.
- primaryOutcome including swelling ability, water vapour transmission rate, hydrogen peroxide production, methylglyoxal content and antibacterial activity
- result Hydrogel showed a good water vapour transmission rate, fluid uptake and were not cytotoxic for fibroblasts. The hydrogel demonstrated good antibacterial activity toward clinically relevant pathogens, including S. aureus and E. coli.
- result No histological changes were observed.
Biomed Mater Eng · PMID 29578463 · Read it on PubMed ↗
Hatami et al. 2018
Comparing the Efficacy of Peritonsillar Injection of Tramadol With Honey in Controlling Post-Tonsillectomy Pain in Adults
No clear healing benefit from honey.Randomised trialLow qualityRelated question
60 people7 days
Pain was higher in the honey group during the first 24 hours; by 7 days pain was similar between groups, and healing of the tonsil area did not differ significantly between groups, though it looked slightly better with tramadol by day 7
Who was studied
Adults aged 18 to 55 having tonsil removal surgery
What they received
Honey taken by mouth after surgery plus acetaminophen
Compared with
Tramadol injected into the tonsil area during surgery
Main outcome
Pain levels and wound healing of the tonsil area after surgery
Quality
Small study of 60 patients with no mention of blinding, and it studied tonsillectomy pain rather than anorectal wound healing with manuka honey specifically.
Limitations
Small sample size, no blinding described, outcome measured only to 7 days, and honey type not specified as manuka honey.
Taken word for word from the abstract
- n This clinical trial was performed on 60 patients
- population 60 patients with American Society of Anesthesia I and II aged between 18 and 55 years and underwent tonsillectomy
- intervention honey dissolved in 40 mL warm water every 6 hours from when the patient was fully awake. Patients in Group A were told to eat honey 3 times a day 7 days postoperatively
- comparator Group B was given tramadol at dose of 2 mg/kg and with volume of 4 mL
- primaryOutcome Pain was scored using Numeric Rating Scale at the time points of 2, 6, 12, and 24 hours as well as 3 and 7 days postoperatively. Moreover, the healing status and epithelialization degree of tonsillar bed were considered on 1 and 7 days after the surgery
- result The mean of pain score was significantly higher in Group A within 24 hours postoperatively as compared with Group B (P < 0.01). The mean of pain score was lower in Group B after 3 and 7 days but this difference was not statistically significant (P > 0.05). Considering restoration status and epithelialization degree of tonsillar bed on the 1st and 7th days, there was no statistically significant difference between 2 groups; however, tonsillar bed healing process was better in Group B on the 7th day.
J Craniofac Surg · PMID 29498972 · Read it on PubMed ↗
Hajizadeh et al. 2018
Effect of Topical Honey on Mandibular Bone Defect Healing in Rats
Faster bone healing in rats.Animal studyLow qualityRelated question
24 people4 weeks
honey group showed faster healing stages and significantly more new bone formation than control at 2 and 4 weeks
Who was studied
rats with surgically created mandibular bone defects
What they received
topical honey placed in the bone defect
Compared with
no honey, defect left unfilled
Main outcome
bone healing assessed histologically and by new bone formation
Quality
small animal study on bone defects, not human wounds or manuka honey, so it offers only indirect, limited evidence for the question asked
Limitations
Animal model with small sample size, not manuka honey specifically, and bone defect healing rather than skin or anorectal wound healing.
Taken word for word from the abstract
- n This animal study was performed on 24 wild-type Wistar rats.
- population a 2 × 2 mm defect was created at mandibular angle
- intervention In the experimental group, the defect was filled with sterile honey
- comparator while it was left unfilled in the control group
- primaryOutcome defects were assessed histologically
- result Histomorphometric assessment revealed that the mean new bone formation in the experimental group was significantly more than the control group, both after 2 and 4 weeks (p = 0.041).
J Contemp Dent Pract · PMID 29358534 · Read it on PubMed ↗
Thamboo et al. 2016
Objective and subjective scar aesthetics with topical Manuka honey post-thyroidectomy: A randomized control study
No improvement in scar appearance.Randomised trialLow qualityRelated question
21 people8 weeks
no significant difference in scar appearance between honey and standard treatment at 4 and 8 weeks
Who was studied
patients who had thyroid surgery with an 8 cm incision
What they received
Manuka honey paste applied daily to the incision for 4 weeks
Compared with
standard treatment without honey
Main outcome
scar appearance rated by patient and by an observer (POSAS scale)
Quality
Very small number of patients (21) and different surgical wounds than anorectal surgery, so results carry limited weight.
Limitations
Small sample size (only 21 patients completed assessment); single-blinded design.
Taken word for word from the abstract
- n A total of 21 patients completed the entire scar analysis (honey treatment = 9, standard treatment = 12).
- population All patients received an 8 cm incision.
- intervention Patients randomized to honey treatment were instructed to apply Manuka honey paste topically to the incision site once per day post surgery for 4 weeks.
- comparator standard treatment = 12
- primaryOutcome The primary outcome measure used was the Patient and Observer Scar Assessment Scale (POSAS).
- result There was no statistically significant difference between patient scar assessment scale and observer scar assessment scale at 4 and 8 weeks postoperatively.
World J Otorhinolaryngol Head Neck Surg · PMID 29204567 · Read it on PubMed ↗
Winter 2017
Medical-Grade Honey Dressing Use in Developing Countries
Honey dressing reportedly worked, no data given.Case seriesVery low qualityRelated question
size not given2017
the provider has successfully used this antimicrobial dressing
Who was studied
wound care patients in developing countries, as treated by one healthcare provider in Africa
What they received
SurgihoneyRO, a bioengineered medical-grade honey wound dressing
Compared with
no controlled comparator described
Main outcome
successful wound care use of the dressing
Quality
this is a descriptive account of one provider's experience with no data, no comparison group, and no measured outcomes.
Limitations
no patient numbers, no quantitative results, and the honey product described (SurgihoneyRO) is not manuka honey, nor is anorectal surgery mentioned.
Taken word for word from the abstract
- intervention SurgihoneyRO (H&R Healthcare Ltd, Southmoor, Abingdon, United Kingdom), a bioengineered medical-grade honey, delivers low concentrations of reactive oxygen to wounds over a sustained period
- population used this new antimicrobial dressing in Africa
- result has successfully used this new antimicrobial dressing in Africa
- primaryOutcome examines the potential positive impact this dressing could have on wound care in developing countries
- comparator Compared with other medical honeys
Adv Skin Wound Care · PMID 29049265 · Read it on PubMed ↗
Halstead et al. 2017
Use of an engineered honey to eradicate preformed biofilms of important wound pathogens: an in vitro study
Killed wound bacteria in a dish.Laboratory studyVery low qualityRelated question
size not given2017
The honey reduced biofilm regrowth and biomass for all 16 bacteria tested, with reductions of 58% to 94.3% at the strongest concentration
Who was studied
Bacteria that commonly infect wounds, grown in lab dishes
What they received
An engineered medical honey called SurgihoneyRO applied directly to bacterial biofilms
Compared with
Untreated bacterial biofilms (no honey)
Main outcome
Whether the honey could break down and reduce already-formed bacterial biofilms
Quality
This was a lab dish experiment on bacteria, not a study of patients or wounds, so it cannot show whether honey helps people heal.
Limitations
In vitro only, no patients or wounds involved, and the honey tested (SurgihoneyRO) is an engineered honey rather than plain manuka honey
Taken word for word from the abstract
- population the mature biofilms of 16 clinically relevant wound pathogens
- intervention SurgihoneyRO (SHRO), an engineered honey
- comparator compared with untreated controls
- primaryOutcome to assess whether SHRO has any antibacterial activity against mature, preformed biofilms
- result percentage reductions ranging from 58% (ACI_C59) to 94.3% (MDR_B) for the strongest concentration of honey (1:3)
- n 16 clinically relevant wound pathogens
J Wound Care · PMID 28795889 · Read it on PubMed ↗
Tavakoli et al. 2017
Honey/PVA hybrid wound dressings with controlled release of antibiotics: Structural, physico-mechanical and in-vitro biomedical studies
Lab test of honey dressing material.Laboratory studyVery low qualityRelated question
size not given2017
The hydrogel with 1% borax showed the best overall properties and all versions were biocompatible in lab tests
Who was studied
Not a patient study; laboratory testing of a wound dressing material
What they received
Honey and PVA hybrid hydrogel wound dressing with borax crosslinking
Compared with
Different crosslinking densities of the same hydrogel (varying borax percentage)
Main outcome
Physical, mechanical and biological properties of the dressing (swelling, permeability, bio-adhesion, cytotoxicity, antibacterial effect, cell proliferation)
Quality
This is a laboratory material-science study with no patients, so it cannot show whether honey helps real wounds heal.
Limitations
In-vitro only; no human or animal wound healing data; not specific to manuka honey or anorectal surgery
Taken word for word from the abstract
- population Comprehensive evaluations of the morphology, swelling kinetics, permeability, bio-adhesion, mechanical characteristics, cytotoxicity, antibacterial property, cell proliferation ability and their controlling release properties were conducted
- intervention a simple method for the preparation of a highly concentrated honey/PVA hybrid hydrogel with borax as the crosslinking agent is reported
- comparator conducted as a function of crosslinking density
- primaryOutcome Comprehensive evaluations of the morphology, swelling kinetics, permeability, bio-adhesion, mechanical characteristics, cytotoxicity, antibacterial property, cell proliferation ability and their controlling release properties were conducted
- result All the borax-induced hydrogels showed acceptable biocompatibility, and the incorporation of 1% borax in the hydrogel formulation produced optimal behaviours for wound addressing applications.
Mater Sci Eng C Mater Biol Appl · PMID 28532035 · Read it on PubMed ↗
Giusto et al. 2017
A new, easy-to-make pectin-honey hydrogel enhances wound healing in rats
Honey hydrogel sped healing; honey alone unclear.Animal studyLow qualityRelated question
36 people2017
Wound healing was faster with honey and with the pectin-honey hydrogel than with control, but only the hydrogel group reached statistical significance
Who was studied
Rats with surgically created skin wounds on their backs
What they received
Liquid Manuka honey applied to the wound, compared with a new pectin-honey hydrogel
Compared with
Pectin hydrogel alone or bandage-only control
Main outcome
Speed of wound area reduction (healing rate)
Quality
Small animal (rat) study with wounds surgically created, not a clinical trial in humans, so it says little about human anorectal surgery wounds.
Limitations
Animal model only, small group sizes, and the liquid honey group's improvement over control was not reported as statistically significant.
Taken word for word from the abstract
- population Thirty-six adult male Sprague-Dawley rats were anesthetized and a 2 × 2 cm excisional wound was created on the dorsum.
- intervention in the LH group, liquid Manuka honey was applied
- comparator in the C group, only bandage was applied to the wound
- primaryOutcome the wound area reduction rate was calculated and compared between groups
- result The wound area reduction rate was faster in the PHH, LH, and Pec groups compared to the control group and was significantly faster in the PHH group.
- n Thirty-six adult male Sprague-Dawley rats were anesthetized
BMC Complement Altern Med · PMID 28511700 · Read it on PubMed ↗
Lazarides et al. 2018
Novel Use of Active Leptospermum Honey for Ringed Fixator Pin Site Care in Diabetic Charcot Deformity Patients
Fewer pin site infections with honey.Case seriesLow qualityRelated question
19 people12.1 weeks
infection rates were significantly reduced compared to the standard care control group
Who was studied
diabetic patients with Charcot deformities of the lower extremity undergoing surgery with external fixation pins
What they received
Leptospermum honey-impregnated dressings applied at the pin sites
Compared with
standard pin site care in a retrospective group of patients who didn't get honey dressings
Main outcome
rate of pin site infections
Quality
this was a small, non-randomized pilot study comparing a prospective group to a separate retrospective control group, so bias and chance can't be ruled out.
Limitations
Pilot data in a prospectively collected case series; authors say a randomized controlled study is still needed; control group was evaluated retrospectively rather than randomized.
Taken word for word from the abstract
- n Of the 21 enrolled patients, 19 underwent OREF and followed up throughout the study period.
- population Twenty-one diabetic patients with Charcot deformities of the lower extremity
- intervention Active Leptospermum honey dressings were applied at metal-cutaneous interfaces at the end of the OREF procedure and replaced weekly for a total of 8 weeks.
- comparator Sixteen consecutive patients receiving standard OREF for Charcot deformities were evaluated retrospectively to serve as a control group.
- primaryOutcome We aimed to demonstrate the safety and efficacy of a novel method of pin site care utilizing active Leptospermum honey-impregnated dressings (MediHoney) in diabetic patients undergoing deformity correction with OREF.
- result Infection rates were significantly reduced when compared to the standard care control group.
Foot Ankle Spec · PMID 28506082 · Read it on PubMed ↗
Zamora et al. 2017
An insight into the antibiofilm properties of Costa Rican stingless bee honeys
Breaks down bacterial biofilm in lab tests.Laboratory studyVery low qualityRelated question
57 people2017
Tetragonisca angustula honeys inhibited bacterial growth and biofilm formation, destroyed existing biofilm, and helped restore antibiotic effectiveness, due to two bee-derived proteins
Who was studied
laboratory-grown Staphylococcus aureus biofilm (not human patients)
What they received
Costa Rican stingless bee (Meliponini) honeys, especially Tetragonisca angustula honey
Compared with
Medihoney (manuka-derived reference honey) and antibiotics alone
Main outcome
ability to inhibit bacterial growth and destroy Staphylococcus aureus biofilm in lab assays
Quality
This is a laboratory dish study of honey against bacteria, not a study in people with wounds, so it cannot show whether it helps real wounds heal.
Limitations
In-vitro laboratory study only, no human or animal wound testing, no clinical outcomes measured.
Taken word for word from the abstract
- population Staphylococcus aureus biofilm forming strain
- intervention Meliponini honeys from Costa Rica were examined along with Medihoney as a reference
- comparator Medihoney as a reference
- primaryOutcome minimum inhibitory concentration, inhibition of biofilm formation and biofilm destruction microplate-based assays against a Staphylococcus aureus biofilm forming strain
- result Costa Rican Tetragonisca angustula honeys can inhibit the planktonic growth, biofilm formation, and are capable of destroying a Staphylococcus aureus biofilm.
- n A total of 57 Meliponini honeys from Costa Rica were studied in this research.
J Wound Care · PMID 28379095 · Read it on PubMed ↗
Tsang et al. 2017
A Pilot Randomized, Controlled Study of Nanocrystalline Silver, Manuka Honey, and Conventional Dressing in Healing Diabetic Foot Ulcer
Honey healed more ulcers than standard care, less than silver.Randomised trialLow qualityRelated question
31 people12 weeks
50% of the manuka honey group had complete healing and ulcer size shrank by about 86%, compared with 40% healing and about 75% size reduction with conventional dressing, while silver dressing performed best (81.8% healing, 97% size reduction)
Who was studied
adults with type 2 diabetes who had diabetic foot ulcers
What they received
Manuka honey dressing
Compared with
nanocrystalline silver dressing and conventional dressing
Main outcome
complete healing of the foot ulcer and reduction in ulcer size
Quality
This was a very small, open-label pilot trial with only 10 people per group and no statistical comparison reported between the healing rates.
Limitations
Pilot study with small sample size, open-label design, and no significance testing reported for differences in healing between groups.
Taken word for word from the abstract
- n 31 participants (11 in the nAg group, 10 in the MH group, and 10 in the convention group) diagnosed with type 2 diabetes were enrolled.
- population diagnosed with type 2 diabetes
- intervention Manuka honey (MH) dressing
- comparator Nanocrystalline silver (nAg) and Manuka honey (MH) dressing have increasing popularity for treating diabetic foot ulcer (DFU).
- primaryOutcome examining the preliminary effectiveness of nAg against MH and conventional dressing in healing DFU in terms of ulcer healing, ulcer infection, and inflammation
- result the proportions of complete ulcer healing were 81.8%, 50%, and 40% in the nAg, MH, and conventional groups, respectively. The ulcer size reduction rate was potentially higher in the nAg group (97.45%) than the MH group (86.21%) and the conventional group (75.17%).
Evid Based Complement Alternat Med · PMID 28239398 · Read it on PubMed ↗
Akhmetova et al. 2016
A Comprehensive Review of Topical Odor-Controlling Treatment Options for Chronic Wounds
Not studied here directly.Narrative reviewVery low qualityRelated question
size not given2016
not specific to honey or anorectal surgery; general review of odor-control options including honey
Who was studied
people with chronic wounds
What they received
topical agents including honey, silver, iodine, sugar, and essential oils for odor control
Main outcome
wound odor control and underlying bacterial infection
Quality
this is a general narrative review about wound odor control, not a study testing manuka honey for healing or anorectal surgery, so it gives no direct evidence on the question.
Limitations
abstract does not describe study methodology, does not focus on manuka honey specifically, and does not address anorectal surgery or wound healing outcomes directly.
Taken word for word from the abstract
- population The process of wound healing is often accompanied by bacterial infection or critical colonization
- intervention multiple topical agents, including silver, iodine, honey, sugar, and essential oils, have been suggested for incorporation into dressings in an attempt to control the underlying bacterial infection
- primaryOutcome Current management focuses on reducing bacterial activity within the wound site and absorbing malodorous gases
- result This review describes options for controlling malodor in chronic wounds, the benefits and drawbacks of each topical agent, and their mode of action.
J Wound Ostomy Continence Nurs · PMID 27684356 · Read it on PubMed ↗
Balaji et al. 2016
Fabrication and hemocompatibility assessment of novel polyurethane-based bio-nanofibrous dressing loaded with honey and Carica papaya extract for the management of burn injuries
Lab dressing material, not tested on wounds.Laboratory studyVery low qualityRelated question
size not given2016
the honey-papaya dressing showed increased water absorption, better wettability, and was non-toxic and compatible with blood in lab tests
Who was studied
no human or animal subjects; laboratory material testing for burn wound dressings
What they received
a new nanofiber wound dressing material made with polyurethane, honey, and papaya extract
Compared with
plain polyurethane dressing without honey/papaya
Main outcome
physical and chemical properties of the dressing material, including water absorption and blood compatibility
Quality
this was only a laboratory material science test of a dressing, not a study on real wounds or patients.
Limitations
no human or animal wound healing was tested; this only examined material properties and blood compatibility in the lab.
Taken word for word from the abstract
- population To assist burn wound management, a novel polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract was fabricated using a one-step electrospinning technique.
- intervention polyurethane (PU)-based bio-nanofibrous dressing loaded with honey (HN) and Carica papaya (PA) fruit extract
- comparator the water absorption ability of the PU-HN-PA nanofiber samples to 761.67% from 285.13% in PU
- primaryOutcome the ability of the bio-nanofibrous dressing to support specific protein adsorption (45%), delay thrombus formation, and reduce hemolysis demonstrated its nontoxic and compatible nature with the host tissues
- result the excellent physicochemical and hemocompatible properties of the developed PU-HN-PA dressing exhibit its potential in reducing the clinical complications associated with the treatment of burn injuries
Int J Nanomedicine · PMID 27621626 · Read it on PubMed ↗
Esser 2017
Leptospermum Honey for Wound Care in an Extremely Premature Infant
Faster healing, less scarring in one infantCase seriesVery low qualityRelated question
size not given2017
quick healing, little to no scarring, no loss of movement or function
Who was studied
a premature newborn (23 weeks gestation) with a severe skin wound
What they received
Leptospermum (manuka) honey dressing
Compared with
hydrogel dressing used first, before switching to honey
Main outcome
wound healing time, scarring, and limb function
Quality
this is a single patient case report, so it cannot show whether honey generally works.
Limitations
single case with no comparison group; abstract notes evidence is lacking in neonates and calls for more research
Taken word for word from the abstract
- n a 23-week gestation infant
- population the management of a difficult-to-heal wound in a 23-week gestation infant
- intervention transitioning to a Leptospermum honey dressing due to suboptimal healing
- comparator using a hydrogel product initially and then transitioning to a Leptospermum honey dressing
- primaryOutcome Results of this treatment included quick healing time, little to no scarring, and no loss of movement or function to the affected extremities.
- result quick healing time, little to no scarring, and no loss of movement or function to the affected extremities
- limitations with evidence lacking in the neonatal population
Adv Neonatal Care · PMID 27611017 · Read it on PubMed ↗
Aziz et al. 2017
The effects of honey compared to silver sulfadiazine for the treatment of burns: A systematic review of randomized controlled trials
Faster healing, more infections cleared.Systematic reviewModerate qualityRelated question
size not given2017
honey healed wounds faster and cleared more infections than silver sulfadiazine
Who was studied
people with burn wounds
What they received
honey dressings
Compared with
silver sulfadiazine dressings
Main outcome
time for wound to heal and number of infected wounds becoming sterile
Quality
Based on nine randomized trials rated as moderate quality evidence, but this is about burns, not anorectal surgery wounds.
Limitations
Abstract does not report study sizes, blinding details, or heterogeneity; honey type not specified as manuka.
Taken word for word from the abstract
- population honey compared with silver dressings on the healing of burn wounds
- intervention honey dressings
- comparator silver sulfadiazine (SSD)
- primaryOutcome The primary endpoints considered were wound healing time and the number of infected wounds rendered sterile.
- result there was a statistically significant difference between the two groups, favoring honey in healing time (MD -5.76days, 95% CI -8.14 to -3.39) and the proportions of infected wounds rendered sterile (RR 2.59; 95% CI 1.58-2.88)
Burns · PMID 27576926 · Read it on PubMed ↗
Kateel et al. 2016
Topical honey for the treatment of diabetic foot ulcer: A systematic review
Safe, but benefit unproven.Systematic reviewLow qualityRelated question
size not given2016
Review found honey dressing was safe, and three of five clinical trials found it worked better than conventional dressing, but overall evidence was not strong enough to judge effectiveness
Who was studied
people with diabetic foot ulcers
What they received
topical honey dressing
Compared with
conventional wound dressing
Main outcome
wound healing and safety of honey treatment
Quality
Based on only five small clinical trials and observational studies with no pooled statistical analysis, and the authors themselves say the data quality is insufficient to judge efficacy.
Limitations
Insufficient good quality data to conclude on efficacy; relies partly on observational studies where efficacy cannot be assessed.
Taken word for word from the abstract
- population treatment of diabetic foot ulcer
- intervention Topical honey has been used for the treatment of wound
- comparator honey dressing is better than conventional dressing
- primaryOutcome showed safety of honey but efficacy cannot be considered from observational studies
- result there is insufficient good quality data to realistically conclude on the efficacy of honey on diabetic foot ulcers
- n Observational studies included total of 320 patients
Complement Ther Clin Pract · PMID 27502813 · Read it on PubMed ↗
Malhotra et al. 2017
Effect of Manuka Honey on Eyelid Wound Healing: A Randomized Controlled Trial
No difference in scars; less reported pain.Randomised trialModerate qualityRelated question
46 people4 months
No significant difference in scar grading scales at any time point, though patients reported less scar pain and stiffness on the honey-treated side
Who was studied
adults having upper eyelid cosmetic surgery (blepharoplasty)
What they received
Manuka honey applied to one eyelid wound twice daily plus Vaseline
Compared with
Vaseline alone on the other eyelid wound
Main outcome
scar appearance and patient-reported wound symptoms over time
Quality
It was a randomized, single-blinded trial with each patient acting as their own control, but it was small and looked at eyelid skin, not anorectal wounds.
Limitations
Small sample size after dropouts, single-blinded design, and results are specific to eyelid surgical wounds rather than anorectal wounds.
Taken word for word from the abstract
- population patients undergoing bilateral upper blepharoplasty
- intervention one eyelid was randomized to receive Manuka honey twice daily
- comparator Vaseline was applied 4 times a day to both sides for 6 weeks
- primaryOutcome Postoperative wounds were graded by a masked observer at 1 week, 1 month, and 4 months using Manchester scar scale and a modified eyelid scar grading scale.
- result At 1 month, all 3 grading scales showed no difference between the 2 sides. At 4 months, scar grading scales showed no differences; however, patients reported scar pain to be significantly less on the Manuka-treated side than control (0.48 vs. 1.9, p = 0.005).
- n 46 (29 women, 17 men, mean age 68 years, median 69, range 49-85) were available for analysis
Ophthalmic Plast Reconstr Surg · PMID 27429228 · Read it on PubMed ↗
Jayalekshmi et al. 2016
Honey on oral mucositis: A Randomized controlled trial
Less severe mouth sores with honey.Randomised trialLow qualityRelated question
28 people6 weeks
Honey group had less severe mouth sores than water group, especially in weeks 4-6
Who was studied
head and neck cancer patients undergoing radiation therapy
What they received
natural honey applied to the mouth
Compared with
plain water applied to the mouth
Main outcome
severity of radiation-induced mouth sores (oral mucositis)
Quality
Very small study with only 28 patients and single-blinding, so results could be due to chance or bias.
Limitations
Small sample size, single-blind design, not studying surgical wounds or manuka honey specifically.
Taken word for word from the abstract
- population The study population included a total of 28 patients.
- intervention Participants in experimental group were given 15ml natural honey for applying on oral mucosa
- comparator in control group 15ml plain water were given
- primaryOutcome severity of oral mucositis was assessed
- result There was a statistically significant difference in degree of oral mucositis between the experimental and control group in week 4, 5 and 6 (p<0.01). During the whole course of study, 9 (64.28 percent) participants in control group developed grade III oral mucositis while only one participant (7.14%) in experimental group developed grade III oral mucositis.
- n The study population included a total of 28 patients.
Gulf J Oncolog · PMID 27050177 · Read it on PubMed ↗
Lindberg et al. 2015
A systematic review and meta-analysis of dressings used for wound healing: the efficiency of honey compared to silver on burns
Honey healed burns faster than silver.Meta-analysisLow qualityRelated question
size not given2015
honey healed wounds faster than silver and had more antibacterial effect
Who was studied
people with burn wounds, mostly from studies conducted in South Asia
What they received
honey dressings applied to wounds
Compared with
silver dressings applied to wounds
Main outcome
how many days it took for wounds to heal
Quality
only six pooled trials from one region, no detail on honey type, bias, or wound severity, and burns are not the same as anorectal surgical wounds.
Limitations
Only six randomised trials included, all from South Asia, abstract gives no detail on trial quality, blinding, or dropout, and the honey type used is not specified as manuka.
Taken word for word from the abstract
- population six randomised controlled trial studies from South Asia focusing on antibacterial properties and healing times of honey and silver
- intervention honey dressings
- comparator silver dressings
- primaryOutcome the number of days needed for wounds to heal
- result Honey was more efficacious for wound healing than silver, as measured in the number of days needed for wounds to heal (pooled risk difference -20, 95% CI -0.29 to -0.11, p < .001)
- result All the included studies based on burns showed the unequivocal result that honey had an even more positive effect than silver on wound healing.
Contemp Nurse · PMID 27027667 · Read it on PubMed ↗
Goharshenasan et al. 2016
Topical Application of Honey on Surgical Wounds: A Randomized Clinical Trial
Smaller, less visible scars with honey.Randomised trialLow qualityRelated question
52 people6 months
honey-dressed side had narrower scars than conventional dressing side at 3 and 6 months
Who was studied
patients having plastic surgery with bilateral symmetric incisions
What they received
honey dressing on surgical wound
Compared with
conventional dressing on surgical wound
Main outcome
appearance/width of the scar
Quality
small single trial using a cosmetic scar measure rather than overall wound healing or infection outcomes, and it's not clear honey type was manuka.
Limitations
Small number of patients, used scar width/appearance rather than broader healing outcomes, not specifically anorectal surgery or manuka honey.
Taken word for word from the abstract
- n Seventy two symmetrical incisions in 52 patients were evaluated during the study.
- population randomly selected plastic surgical patients
- intervention honey dressing
- comparator conventional dressing
- primaryOutcome The aesthetic outcome of the two sides was rated on a Visual Analog Scale by the surgeon and the patient and compared at month three and six after surgery.
- result The mean width of the scar after the third and the sixth month was 3.64 +/- 0.83 mm and 3.49 +/- 0.87 mm on the side that received honey dressing and 5.43 +/- 0.05 mm and 5.30+/- 1.35 mm in the control group.
Forsch Komplementmed · PMID 26977860 · Read it on PubMed ↗
Halstead et al. 2016
In vitro activity of an engineered honey, medical-grade honeys, and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates
Stops bacterial biofilms in lab tests.Laboratory studyVery low qualityRelated question
16 people2016
engineered honey was most potent at stopping biofilm formation, working at lower dilutions than manuka honeys for some isolates and equal for others, and beat honey-containing dressings
Who was studied
bacterial isolates that form biofilms (in vitro, not patients)
What they received
engineered honey (Surgihoney RO) and medical-grade manuka honeys
Compared with
antimicrobial wound dressings containing honey, and untreated controls
Main outcome
ability to prevent bacterial biofilm formation in lab dishes
Quality
This is a lab dish test on bacteria, not a study of people or wounds healing, so it cannot show whether honey helps patients.
Limitations
In vitro testing only on bacterial isolates; no patients, wounds, or clinical healing outcomes were studied; funder provided one product free of charge.
Taken word for word from the abstract
- population to prevent the formation of biofilms by 16 isolates
- intervention three medical-grade honeys SH1, Activon manuka honey (MH) and Medihoney manuka honey (Med)
- comparator five antimicrobial dressings (AMDs)
- primaryOutcome investigate the ability of the engineered honey and its comparators to prevent biofilm formation in vitro
- result SH1 was the most potent, with efficacy at lower dilutions than the medical honeys for five isolates, and equivalent dilutions for a further six
- n by 16 isolates
J Wound Care · PMID 26878302 · Read it on PubMed ↗
Aznan et al. 2016
Effect of Tualang honey on the anastomotic wound healing in large bowel anastomosis in rats-A randomized controlled trial
Stronger gut healing in rats.Animal studyLow qualityRelated question
30 people7 days
Honey-treated rats had significantly stronger anastomosis and better healing markers (more fibroblasts, fewer inflammatory cells); no significant difference in new blood vessel formation
Who was studied
Wistar rats with surgically created bowel connections (anastomosis)
What they received
Oral Tualang honey (1.0 g/kg daily for 7 days after surgery)
Compared with
Standard rat chow and water only
Main outcome
Strength and healing quality of the surgical bowel connection
Quality
This is a small animal study, so it cannot reliably predict what happens in human patients.
Limitations
Small sample size (30 rats), animal model not human, and honey type (Tualang, not manuka) and administration (oral, not topical wound application) differ from the question being asked.
Taken word for word from the abstract
- population Thirty male Wistar rats were given a 3 centimeter infra-umbilical laparotomy wound
- intervention TH 1.0 g/kg every morning until day seven post operatively
- comparator Group I was fed with standard rat chow and water
- primaryOutcome anastomotic bursting pressures were measured and histopathological examination on the anastomosis line was performed
- result the tensile strength of colon anastomosis (95 % CI; p = <0.001) and the histopathological study including fibroblast count (p = <0.001) and inflammatory cells (p = 0.002) showed statistically significant difference in the favor of TH-treated group
- n Thirty male Wistar rats
BMC Complement Altern Med · PMID 26803744 · Read it on PubMed ↗
Dina Jarjis et al. 2016
Post-bariatric abdominoplasty resulting in wound infection and dehiscence-Conservative treatment with medical grade honey: A case report and review of literature
Wound healed well with honeyCase seriesVery low qualityRelated question
1 people2016
The wound healed well with good improvement and patient satisfaction
Who was studied
A 40-year-old woman with a wound infection and wound separation after a tummy tuck following massive weight loss
What they received
Topical Manuka honey applied to the wound
Compared with
No comparison group (single case)
Main outcome
Wound healing and clinical improvement
Quality
This is a single patient case report, so it cannot show whether honey generally works for wound healing.
Limitations
Single case report, no comparison group, not anorectal surgery, author states more research is needed
Taken word for word from the abstract
- n A 40 year-old female suffered wound infection and dehiscence after undergoing post-bariatric abdominoplasty.
- population A 40 year-old female suffered wound infection and dehiscence after undergoing post-bariatric abdominoplasty.
- intervention conservative wound treatment with topical Manuka honey was instituted
- comparator The patient was not interested in surgical revision and split skin grafting.
- primaryOutcome resulting in significant clinical improvement and effective healing concurrently with good patient satisfaction
- result resulting in significant clinical improvement and effective healing concurrently with good patient satisfaction
Int J Surg Case Rep · PMID 26773204 · Read it on PubMed ↗
Imran et al. 2015
A Randomized, Controlled Clinical Trial of Honey-Impregnated Dressing for Treating Diabetic Foot Ulcer
Faster, more complete wound healing.Randomised trialModerate qualityRelated question
348 people120 days
more wounds fully healed and faster healing with honey dressing than saline
Who was studied
patients with diabetic foot ulcers (grade 1 and 2)
What they received
honey-impregnated wound dressing
Compared with
normal saline dressing
Main outcome
proportion of wounds completely healed
Quality
it was a randomized trial with a reasonably large number of patients, but it used a different type of honey (Beri-honey) on diabetic foot ulcers, not manuka honey or anorectal surgery wounds.
Limitations
Abstract does not report blinding, allocation concealment, or dropout details.
Taken word for word from the abstract
- n group A (n=179) treated with honey dressing and group B (n=169) treated with normal saline dressing
- population Patients with Wagner's grade 1 and 2 ulcers were enrolled.
- intervention Beri-honey-impregnated dressing on diabetic foot ulcer
- comparator compare it with normal saline dressing
- primaryOutcome proportion of wounds completely healed (primary outcome)
- result One hundred and thirty six wounds (75.97%) out of 179 were completely healed with honey dressing and 97 (57.39%) out of 169 wtih saline dressing (p=0.001).
J Coll Physicians Surg Pak · PMID 26454386 · Read it on PubMed ↗
Molan et al. 2015
Honey: A Biologic Wound Dressing
Explains why honey may help, no data.Narrative reviewVery low qualityRelated question
size not given2015
The abstract describes mechanisms by which honey, especially manuka honey, promotes wound healing, antibacterial action, immune stimulation, anti-inflammatory effects, and debridement, but reports no specific comparative outcome data
Who was studied
people with wounds
What they received
honey used as a wound dressing (including manuka honey)
Compared with
not reported
Main outcome
wound healing process and related biological effects
Quality
This is a narrative review explaining mechanisms rather than presenting original comparative trial data, so it cannot establish whether honey improves healing outcomes.
Limitations
No study design, patient numbers, comparator, or outcome data are reported; it is a mechanistic/narrative review, not a clinical trial.
Taken word for word from the abstract
- population Honey has been used as a wound dressing for thousands of years
- intervention In manuka honey, the activity is due to methylglyoxal which is not inactivated.
- primaryOutcome it is now realized that honey is a biologic wound dressing with multiple bioactivities that work in concert to expedite the healing process.
- result There is good evidence for honey also having bioactivities that stimulate the immune response (thus promoting the growth of tissues for wound repair), suppress inflammation, and bring about rapid autolytic debridement.
- comparator There is much variation in potency between different honeys.
Wounds · PMID 26061489 · Read it on PubMed ↗
Holland et al. 2015
Medical grade honey in the management of chronic venous leg ulcers
No conclusive evidence honey helps.Systematic reviewLow qualityRelated question
5 people2015
mixed findings across studies, with no conclusive evidence of benefit
Who was studied
people with chronic venous leg ulcers
What they received
medical grade honey applied to the wound
Compared with
standard wound therapy
Main outcome
wound healing and related clinical outcomes
Quality
this is a review of only five studies, including conflicting trials and weaker cohort/case series evidence with methodological flaws
Limitations
contradictory randomised trial results, one trial showing more adverse effects, and two supporting studies described as lower grade evidence with numerous methodological faults
Taken word for word from the abstract
- n of which five represented the best evidence available to answer the clinical question
- population In patients with chronic venous leg ulcers (CVLU)
- intervention the use of medical grade honey
- comparator as compared to standard wound therapy
- primaryOutcome improve clinical outcomes
- result there is no conclusive evidence that honey improves outcome in patients with CVLU, and until more robust trials are conducted, its benefit should be considered unproven
Int J Surg · PMID 26050953 · Read it on PubMed ↗
Calderon et al. 2015
Combined therapy of Ulmo honey (Eucryphia cordifolia) and ascorbic acid to treat venous ulcers
All ulcers fully healed.Case seriesVery low qualityRelated question
18 people2015
all ulcers fully healed with no complications
Who was studied
adults with venous leg ulcers
What they received
topical Ulmo honey dressings plus oral vitamin C
Compared with
no comparison group
Main outcome
complete healing of venous ulcers
Quality
This was a small, uncontrolled study of only 18 patients with no comparison group, so it can't show the honey caused the healing.
Limitations
No control group, small sample size, descriptive design only
Taken word for word from the abstract
- n 18 patients were assessed
- population patients with venous ulcers
- intervention Ulmo honey was topically applied daily
- intervention combined with the daily oral consumptions of 500 mg of ascorbic acid
- comparator longitudinal and descriptive quantitative study
- primaryOutcome full healing was achieved in 100% of the venous ulcers
- result full healing was achieved in 100% of the venous ulcers. No signs of complications were observed, such as allergies or infection.
Rev Lat Am Enfermagem · PMID 26039296 · Read it on PubMed ↗
Mohamed et al. 2015
The efficacy and safety of natural honey on the healing of foot ulcers: a case series
Foot ulcers healed well with honey.Case seriesVery low qualityRelated question
12 people4 weeks
all ulcers healed with no scars, average healing time 3 weeks
Who was studied
patients with chronic foot ulcers
What they received
natural honey applied to the wound with non-adhering dressing
Compared with
none (no control group)
Main outcome
wound healing time
Quality
This was a small uncontrolled observation of only 12 patients with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
No control group, small number of patients, and foot ulcers rather than anorectal surgical wounds.
Taken word for word from the abstract
- n A total of 12 patients with foot ulcers
- population a variety of chronic foot ulcers
- intervention natural honey was applied and the wound was covered by glycerin-impregnated gauze
- comparator natural honey as an effective alternative to more expensive, advanced wound products
- primaryOutcome the efficacy, cost-effectiveness, and acceptability of natural honey on the healing of a variety of chronic foot ulcers
- result All ulcers healed with no contractures or scars with a mean healing time of 3 weeks.
- followUp Patients were followed on a daily basis for an average of 4 weeks.
Wounds · PMID 25855854 · Read it on PubMed ↗

How we searchedThe exact query, the date it ran, and what came back — so you can run it yourself.

Searched: PubMed · ClinicalTrials.gov · Crossref on 2026-10-05
The exact search — paste this into PubMed to repeat it: ("Honey"[Mesh] OR manuka[tiab]) AND ("Wound Healing"[Mesh] OR "Wounds and Injuries"[Mesh] OR wound*[tiab]) AND (surg*[tiab] OR anorectal[tiab] OR hemorrhoidectomy[tiab] OR "anal fistula"[tiab] OR "pilonidal sinus"[tiab] OR dressing*[tiab]); PubMed expanded that to: ("Honey"[MeSH Terms] OR "manuka"[Title/Abstract]) AND ("Wound Healing"[MeSH Terms] OR "Wounds and Injuries"[MeSH Terms] OR "wound*"[Title/Abstract]) AND ("surg*"[Title/Abstract] OR "anorectal"[Title/Abstract] OR "hemorrhoidectomy"[Title/Abstract] OR "anal fistula"[Title/Abstract] OR "pilonidal sinus"[Title/Abstract] OR "dressing*"[Title/Abstract])
What came back: 358 records found · 200 read · 142 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Records reporting no outcome
Retracted publications, which are listed but excluded from every count
Limits: Details were read from abstracts, not full papers, so anything reported only in a paper's methods section is not captured here.
Fields were read from abstracts, not full text, so detail reported only in a paper's methods section is not captured.
Evidence strength is adapted from the GRADE framework. It is not a GRADE assessment and was not produced by a GRADE panel.

358records came back from the search
200were read
142actually answered the question

Common questionsShort answers, drawn from the same studies.

Has manuka honey been tested after hemorrhoidectomy or anal fistula surgery specifically?: No. The only anorectal study found is a trial on pilonidal sinus wounds, which found no significant difference in healing time between honey and standard dressing alone. No trial has looked at hemorrhoidectomy or fistula surgery wounds.
Should I stop using manuka honey on my wound?: If a clinician recommended it as part of your care, ask them directly, since some studies found it can slow healing or irritate wounds in other settings. Don't substitute it for the wound care your surgeon has actually prescribed.
Is manuka honey safe to put on an open wound?: It isn't clearly unsafe, but it isn't clearly safe either. Some studies found it slowed healing or damaged tissue, and one case report linked topical honey to a serious infection concern in an infant, so open or deep wounds deserve caution.
If honey doesn't clearly help, what does help anorectal wounds heal?: The studies reviewed here don't test alternatives like sitz baths or specific dressings in anorectal surgery, so this review can't recommend a replacement. Follow the aftercare plan your surgeon gave you, and ask them about options if the wound isn't healing well.
Why do so many studies seem to say honey helps wounds?: Most of those studies are about different wounds entirely, such as diabetic foot ulcers, burns, or dental sockets, not anorectal surgery. They can't be read as direct evidence for this specific question.
Should I stop using manuka honey on my wound?: If you're using it after anorectal surgery, there's no good evidence it helps, and some studies in other wound types found it actually slowed healing or caused tissue damage. It's reasonable to stop and use the wound care your surgeon recommends instead, such as sitz baths and standard dressings; if you have concerns, ask your surgeon before changing anything.

This is information, not advice

This page summarises published research. It cannot tell you what is happening in your own body, and evidence changes. If something is bleeding, painful, or new, it is worth being looked at — that is a different question from the one on this page, and a better one to bring to a consultation.

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Automated evidence review — PubMed, ClinicalTrials.gov, Crossref. Search strategy, grading rules and the checks that must pass before anything publishes were written by Allen Kamrava, MD, MBA, FACS, FASCRS, colon & rectal surgery, Beverly Hills. The pages themselves are compiled by software running that method and are not read one by one before publication — saying otherwise would be the one claim here that could not be checked.

Allen Kamrava, MD, MBA, FACS, FASCRS · 435 N. Bedford Dr., Suite 308, Beverly Hills, CA 90210 · 424.279.8222

Educational information — not medical advice.