Does manuka honey help heal wounds after hemorrhoidectomy, fistulotomy or pilonidal cyst surgery?

No study has tested this directly. The closest trial was in people with non-healing pilonidal wounds, and it used honey that wasn't confirmed to be manuka; it found no statistically significant difference in healing time between adding honey and not [36].

Is it safe to put manuka honey on a surgical wound?

Across the studies reviewed, no serious injury from applying honey to a wound was reported. One review of chronic wounds did note more pain during treatment with honey dressings in some studies [20], but safety specifically after anorectal surgery hasn't been tested.

Should I stop using manuka honey on my wound?

If your surgeon has given you a specific wound-care routine, follow that rather than substituting honey — there's no evidence manuka honey heals anorectal surgical wounds faster or better. Using it alongside standard care, if your surgeon agrees, hasn't been shown to cause harm in the studies reviewed.

Why do so many articles say manuka honey helps wounds heal?

Most of that evidence comes from laboratory dishes, mice, or unrelated wound types like diabetic foot ulcers — not anorectal surgery. Even in those other settings results are mixed, with some studies finding benefit and others finding no difference or slower healing [9,20,69].

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

Name: Does manuka honey help wounds heal, including after anorectal surgery?
Published: 2026-10-14
Keywords: Manuka Honey for Wound Healing

In patients with open wounds, including those following anorectal surgery (hemorrhoidectomy, fistulotomy, pilonidal sinus excision), does topical manuka honey applied to the wound improve healing time, infection rate, or pain compared with standard wound care or no honey?

Evidence review in plain language · compiled 2026-10-14 · checked 2026-10-14 · next 2026-11-14 · automated review, how it works

Bottom line

No study has tested whether manuka honey helps wounds heal after hemorrhoidectomy, fistulotomy, or pilonidal sinus surgery.

The only trial in a closely related surgery — people with non-healing pilonidal sinus wounds — used honey that wasn't confirmed to be manuka, and found no statistically significant difference in healing time (61 days with honey vs 78 days without) [36]. The other studies found cover different wounds entirely, such as diabetic ulcers, caesarean cuts, dental sockets, and pressure sores, so they cannot answer this specific question.

How certain

Very low

The 46 human studies found measure a related question rather than this one, so they can only be read indirectly.

What it shows

Not studied

No study has measured this in people with this condition.

answer it directly: 0answer it directly
studies found: 95studies found
randomised trials: 14randomised trials
people studied: 59,845people studied
reviews of trials: 11reviews of trials
years covered: 2017–2026years covered

What the research shows

Time to complete wound healing (days)
No trial has measured this with manuka honey in people recovering from hemorrhoidectomy, fistulotomy, or pilonidal sinus surgery. The closest trial, in people with non-healing pilonidal wounds, tested honey of unconfirmed type and found average healing time was not significantly different (61 days with honey vs 78 days without) [36].[1]
Not studied
Wound infection rate
No study has measured infection rates with manuka honey specifically after anorectal surgery.
Not studied
Postoperative pain score
No trial has measured pain scores with manuka honey after anorectal surgery. The nearest related evidence comes from childbirth-related wounds (episiotomy), where honey of unspecified type reduced pain partway through healing compared with placebo, but made no difference to final healing by day 14 [26].[1]
Not studied
Wound size reduction at follow-up
This has not been measured in people after anorectal surgery. A mouse study found faster wound-size reduction with manuka honey compared with saline, but mice are not people [1].[1]
Not studied
Rate of wound dehiscence
No study has reported wound dehiscence (reopening) rates with manuka honey after anorectal surgery or any closely similar surgical wound.
Not studied
Patient-reported healing satisfaction
No study has asked people recovering from anorectal surgery how satisfied they were with manuka honey wound care.
Not studied

Important limitations

The one trial in a closely related surgery — non-healing pilonidal sinus wounds — used honey whose type was not confirmed to be manuka, and its result was not statistically significant.[1]
Most of the other related studies are in different wound types — diabetic foot ulcers, caesarean and episiotomy wounds, pressure sores — so results may not apply to anorectal surgical wounds.[1,2,3,4]
Many studies combine manuka honey with other active ingredients such as curcumin, collagen, or nanoparticles, or use animal and laboratory models only, so manuka honey's own effect on human wounds cannot be separated out.[1,2,3,4,5]
Most studies, including the few randomised trials, are rated low or very low quality, with small sample sizes and little or no blinding.[1,2,3,4]

Why people try it

Manuka honey is marketed as a natural, antibacterial alternative to conventional dressings, which appeals to people wanting a 'natural' option for wound care.
Product packaging and articles often cite laboratory and animal studies showing antibacterial or healing effects, even though these don't involve real patients.
Individual success stories and case reports describing healed wounds can feel convincing, even without a comparison group to judge against.
Honey has a long traditional reputation as a wound remedy, which builds trust separate from clinical trial evidence.

What the studies found

Found a benefit51 · 54%
Found no clear effect7 · 7%
Mixed or unclear30 · 32%
Found possible harm1 · 1%

What kind of studies

Animal study28 · 29%
Case series17 · 18%
Randomised trial14 · 15%
Narrative review11 · 12%
Laboratory study10 · 11%
Meta-analysis9 · 9%
Prospective cohort2 · 2%
Systematic review2 · 2%
Retrospective1 · 1%
Registry1 · 1%

The studies that decided it

Yao et al. 2026
Honey dressing for diabetic foot ulcers: a systematic review and meta-analysis of randomized controlled trials
Faster healing, diabetic foot ulcers (not anorectal wounds)Meta-analysisLow qualityRelated question
1,423 people4 to 24 weeks
honey dressing improved complete healing rates and reduced time to healing compared to conventional dressings
Who was studied
patients with diabetic foot ulcers
What they received
honey dressing (type of honey not specified as manuka)
Compared with
conventional wound dressings
Main outcome
rate of complete wound healing and time to complete healing
Quality
this is a meta-analysis of 16 RCTs, but the evidence was graded low quality for healing time and only moderate for healing rate, and it studies diabetic foot ulcers rather than the anorectal surgery wounds in question.
Limitations
the abstract does not specify manuka honey as the type used, and the population is diabetic foot ulcer patients, not anorectal surgery patients; quality of evidence graded low for time to healing and moderate for healing rate.
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 compared to conventional dressings in the treatment of DFUs
- comparator compared to conventional dressings
- primaryOutcome Primary outcomes were complete wound healing rate and time to complete healing.
- result Meta-analysis showed that 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.
Front Endocrinol (Lausanne) · PMID 41928876 · 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 more painMeta-analysisVery low qualityRelated question
906 people2024
Honey dressings sped up wound healing time and increased percent of wound healed, but showed no difference in overall healing rate, bacterial clearance time, or hospital stay, and may cause more pain during treatment
Who was studied
people with chronic wounds
What they received
topical honey dressings on wounds
Compared with
other/standard wound dressings (not specified in abstract)
Main outcome
time for the wound to heal and percentage of wound healed
Quality
The authors themselves rated the evidence as very low quality due to risk of bias, inconsistent results across studies, and signs of publication bias.
Limitations
Evidence rated very low quality due to risk of bias, inconsistency between studies, and publication bias; studies covered general chronic wounds, not specifically anorectal surgical wounds or manuka honey alone.
Taken word for word from the abstract
- population management of chronic wounds
- intervention honey dressings
- comparator significant acceleration in wound healing time with honey dressings (MD = -17.13, 95% CI -26.37 to -7.89, p = 0.0003)
- primaryOutcome 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.
- n A total of eight studies, including 906 individuals that met the inclusion criteria, were incorporated.
- harm Honey may decrease the VAS score but may increase the incidence of painful discomfort during treatment.
Nutrients · PMID 39125335 · Read it on PubMed ↗
Ferraz Barbosa et al. 2024
The Use of Honey for Cicatrization and Pain Control of Obstetric Wounds: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
No difference in healing, less painMeta-analysisModerate qualityRelated question
353 people2024
no difference in final wound healing, but less pain mid-treatment, less need for pain medicine, higher satisfaction, and fewer complications with honey
Who was studied
women with wounds from childbirth (obstetric wounds, e.g. episiotomy)
What they received
honey applied to the wound
Compared with
placebo
Main outcome
wound healing and pain control
Quality
it pools only five small randomized trials with a modest total number of patients, and the wounds studied are not anorectal surgical wounds.
Limitations
small number of included trials; wounds studied were obstetric (childbirth-related), not anorectal surgical wounds; honey type not specified as manuka.
Taken word for word from the abstract
- population comparing honey and a placebo for obstetric wounds
- intervention treated with honey
- comparator compare honey versus a placebo for cicatrization and pain control of obstetric wounds
- primaryOutcome The primary outcomes were wound healing and pain control.
- result Differences were not found in the final wound healing between the honey and placebo groups (MD -0.34; 95% CI -1.13, 0.44; p = 0.39); however, there was a decrease in pain levels in the middle of the treatment (SMD -0.54; 95% CI 0.83 to 0.25, p = 0.03), reduction in the use of pain medication (ORR 0.26; 95% CI 0.08, 0.86; p = 0.03), increase in personal satisfaction in women who underwent the intervention (ORR 0.81; 95% CI 0.65, 0.98), and reduction in complications.
- n Five randomized controlled trials and 353 patients were included, of whom, 177 (50.1%) were treated with honey.
Nutrients · PMID 38257078 · 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 timeRandomised trialModerate qualityRelated question
100 people2023
average healing time was 61 days with honey versus 78 days without, but the difference was not statistically significant
Who was studied
patients with a wound that hadn't healed 6 weeks after surgery for a pilonidal cyst
What they received
alginate wick dressing plus honey
Compared with
alginate wick dressing alone
Main outcome
time for the wound to heal
Quality
it was a randomized trial but small, single-center, and the honey type was not specified as manuka, and the main result did not reach statistical significance
Limitations
the trial did not reach significance on its primary endpoint and honey type was not specified as manuka
Taken word for word from the abstract
- 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).
- n Fifty patients were included in each arm.
Tech Coloproctol · PMID 36598614 · 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 wound shrinkage; antibiotic worked better.Animal studyLow qualityRelated question
50 people8 days
Manuka honey did not reduce bacterial count or wound area; gentamicin reduced wound area significantly more, though bacterial counts were similar between groups at end of treatment
Who was studied
Pigs with infected surgical wounds (porcine wound model)
What they received
Topical manuka honey applied to wound
Compared with
Intramuscular gentamicin (systemic antibiotic)
Main outcome
Bacterial count and wound area reduction over 8 days of treatment
Quality
This was a small animal pilot study using only two pigs, so it cannot reliably predict how manuka honey works in human wounds.
Limitations
Animal model (pigs, not humans), only two animals total, pilot study design, not anorectal surgery wounds
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 were infected with S. aureus
Injury · PMID 34756413 · 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 dressings healed wounds faster than iodine.Meta-analysisLow qualityRelated question
1,236 people2021
Honey dressings linked to shorter healing time, shorter hospital stay, and less pain than povidone iodine dressings
Who was studied
People with wounds (various types) treated with dressings
What they received
Honey-based wound dressings
Compared with
Povidone iodine-based wound dressings
Main outcome
Wound healing time, length of hospital stay, and pain scores
Quality
It pools 12 different studies on honey in general (not manuka honey specifically) without describing the quality or risk of bias of those individual trials.
Limitations
The abstract does not specify manuka honey, does not describe the types of wounds included (e.g., whether anorectal surgery wounds were included), and gives no detail on individual study quality or bias.
Taken word for word from the abstract
- population 12 manuscripts with a total of 1236 participants (mean age: 40.7±11.7 years) were included
- 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.
- n 12 manuscripts with a total of 1236 participants
J Wound Care · PMID 33856925 · Read it on PubMed ↗
Lu et al. 2020
A Comparison of the Wound Healing Efficacy of Trolamine Emulsion, Manuka Gel, and Polymyxin-Bacitracin Ointment
Healed slower than trolamine cream.Prospective cohortLow qualityRelated question
29 people2020
Wounds treated with manuka honey healed slower than those treated with trolamine emulsion (19 vs 15 days, statistically significant)
Who was studied
Adults having seborrheic keratosis lesions removed by scraping (not anorectal surgery patients)
What they received
Manuka honey gel applied to the wound
Compared with
Trolamine emulsion and polymyxin-bacitracin ointment applied to similar wounds on the same patient
Main outcome
Time for the wound to fully heal
Quality
Very small study (29 people) in a different wound type (skin lesion removal, not anorectal surgery) with no mention of randomization.
Limitations
Small sample size, wounds were from cosmetic skin lesion removal rather than anorectal surgery, and the abstract does not state the study was randomized.
Taken word for word from the abstract
- n Wound healing was studied in 29 participants
- population In each participant, three similarly sized and located seborrheic keratoses were removed by curettage.
- intervention manuka honey gel
- comparator trolamine emulsion, manuka honey gel, or polymyxin-bacitracin ointment
- primaryOutcome Resultant wounds were treated with either trolamine emulsion, manuka honey gel, or polymyxin-bacitracin ointment until the wounds were fully healed.
- result Wounds treated with trolamine emulsion healed significantly faster than wounds treated with either manuka honey or polymyxin-bacitracin (15 vs 19 days; P < .001).
Adv Skin Wound Care · PMID 32195725 · Read it on PubMed ↗
Dreyfus et al. 2018
Clostridial collagenase ointment and medicinal honey utilization for pressure ulcers in US hospitals
More return visits than other treatmentRegistryLow qualityRelated question
50,866 people6 months
Patients treated with medicinal honey had more hospital or outpatient return visits than those treated with clostridial collagenase ointment
Who was studied
Hospital patients with pressure ulcers (pressure sores)
What they received
Medicinal honey used to debride (clean) the wound
Compared with
Clostridial collagenase ointment (a different debriding treatment)
Main outcome
How often patients had to return to the hospital or clinic within 6 months
Quality
This was a retrospective records review without randomization, so differences between groups could explain the result rather than the honey itself.
Limitations
Observational design, no adjustment for the reason patients were hospitalized or returned, possible selection bias between treatment groups
Taken word for word from the abstract
- population pressure ulcer (PU) patients
- intervention medicinal honey debridement methods
- comparator clostridial collagenase ointment (CCO)
- primaryOutcome compare the frequency of healthcare re-encounters between CCO- and medicinal honey-treated patients
- result Patients with CCO-treated PUs returned to inpatient and outpatient hospital settings less often compared with medicinal honey-treated PUs.
- n The study identified 48,267 inpatients and 2,599 outpatients with PUs treated with CCO or medicinal honeys.
J Med Econ · PMID 29295637 · Read it on PubMed ↗

What actually helps, on this site

Treatments Dr. Kamrava performs for this:

More about the condition:

All 95 studiesEvery study that answered the question, with its design, size and result.

The other 88 studiesEverything else the search returned, including anything retracted.

Subramanyam et al. 2026
Immunomodulatory effect of Manuka honey on macrophage polarisation and its impact on acute wound healing: An experimental study in Swiss albino mice
Faster wound healing in mice.Animal studyLow qualityRelated question
30 people10 days
Manuka honey group had greater wound size reduction (77.3% vs 69.6%) and better healing markers on tissue tests
Who was studied
Mice with surgically created skin wounds
What they received
Topical manuka honey applied to wounds
Compared with
Saline applied to wounds
Main outcome
Percentage reduction in wound size over 10 days
Quality
This is a small animal experiment, not a human study, so it cannot show whether manuka honey helps human wounds, especially after anorectal surgery.
Limitations
Animal study in mice, not humans; small sample size; does not include anorectal surgery patients.
Taken word for word from the abstract
- n Thirty male Swiss albino mice (8-12 wk; 25-30 g) were randomised equally to Manuka honey (test) or saline (control)
- population two dorsal full-thickness wounds (1.0 cm) per animal treated daily for 10 days
- intervention Manuka honey (test)
- comparator saline (control)
- primaryOutcome The primary outcome was wound healing rate (WHR; % reduction in wound area from day 0 to day 10
- result The test group achieved a higher WHR at day 10 (77.3±5.9% vs. 69.6±5.1%; P=0.003).
Indian J Med Res · PMID 42555681 · Read it on PubMed ↗
Nowak et al. 2026
Botanical Origin-Dependent Phytochemical Profiles and Pharmaceutical Properties of Medical-Grade Honeys: Transdermal Delivery and Antibacterial Efficacy in a Wound Fluid Model
Mixed lab results; chestnut honey healed betterLaboratory studyVery low qualityRelated question
size not given2026
Manuka honey had the most diverse polyphenols and best skin penetration, but chestnut honey showed better wound closure (fibroblast migration) and stronger antibacterial activity than manuka honey
Who was studied
No human patients; laboratory wound-healing and skin-penetration models (cell scratch assay, porcine skin, artificial wound fluid)
What they received
Manuka honey (medical-grade) tested in vitro/ex vivo for wound healing, antibacterial activity, and skin penetration
Compared with
Chestnut honey and multifloral honey tested under the same laboratory conditions
Main outcome
Wound closure (scratch assay), antibacterial efficacy, and transdermal penetration of phenolic compounds
Quality
This is a laboratory study using cells, skin samples, and artificial wound fluid, not real patients or surgical wounds, so it cannot show whether manuka honey helps people heal.
Limitations
No human subjects, no anorectal surgery patients, purely in vitro/ex vivo laboratory comparison of honey types
Taken word for word from the abstract
- population Wound healing activity was assessed using a scratch assay, transdermal penetration of phenolic acids through porcine skin using Franz diffusion cells, and antibacterial efficacy by MIC assay with and without artificial wound fluid exudate.
- intervention This study evaluated the wound-healing potential, antibacterial efficacy, and transdermal penetration capacity of three commercially available MGHs: manuka (MH), chestnut (ChH), and multifloral honey (MFH).
- comparator three commercially available MGHs: manuka (MH), chestnut (ChH), and multifloral honey (MFH)
- primaryOutcome Wound closure capacity in the scratch assay was honey type-dependent, with ChH showing the most favorable fibroblast migratory response.
- result MH exhibited the greatest polyphenol diversity, with gallic acid predominating (101.09 µg/g), and superior transdermal penetration attributable to elevated fatty acid content.
- result Wound closure capacity in the scratch assay was honey type-dependent, with ChH showing the most favorable fibroblast migratory response. ChH also exhibited the highest antibacterial activity and H2O2 generation in wound fluid exudate.
Molecules · PMID 42280166 · Read it on PubMed ↗
Fang et al. 2026
Impact of advanced wound care methods on obstetric patients: a meta-analysis
No benefit shown, but not about manuka honey or anorectal wounds specificallyMeta-analysisLow qualityRelated question
1,977 people2026
no statistically significant difference between advanced wound care and standard treatments (pooled risk ratio 0.97, 95% CI 0.81 to 1.16)
Who was studied
obstetric patients with surgical wounds from procedures like caesarean sections and episiotomies
What they received
advanced wound care methods including bioactive dressings, topical antimicrobials and medicated creams such as aloe vera, honey, and turmeric gels
Compared with
standard wound care methods
Main outcome
wound healing
Quality
this pools many different treatments (not just honey) across obstetric patients with high variability between studies, so it can't tell you much about manuka honey specifically or about anorectal wounds.
Limitations
substantial heterogeneity across studies (I2=78%); honey is only one of several pooled interventions, not isolated; population is obstetric, not anorectal surgery patients.
Taken word for word from the abstract
- 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 compared to standard methods in obstetric patients
- primaryOutcome 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
- n A total of 11 studies comprising 1977 patients were analysed.
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-only promising cell resultsLaboratory studyVery low qualityRelated question
size not given2026
The scaffold showed no toxicity, improved cell migration and proliferation, and had strong antioxidant activity in lab testing
Who was studied
Laboratory cell cultures (human umbilical vein endothelial cells), not patients
What they received
A lab-made scaffold combining manuka honey with fenugreek extract and ghrelin in a silk-fibroin/PVA material
Main outcome
Cell toxicity, cell migration, proliferation, and antioxidant activity in lab tests
Quality
This is an early-stage lab experiment on cells, not a study in real wounds or patients, and manuka honey was only tested as part of a mixture with other ingredients.
Limitations
No human or animal wound testing; manuka honey combined with other active ingredients so its individual effect cannot be isolated; no patient population or anorectal surgery context.
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.
- result Scratch assays confirmed enhanced migration of human umbilical vein endothelial cells, supporting the scaffold's angiogenic potential. Additionally, the scaffold exhibited superior antioxidant activity and significantly improved cell proliferation.
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
Promising but unproven for wound healing.Narrative reviewVery low qualityRelated question
size not given2026
Clinical studies show reduced bacterial load, faster healing and improved comfort in surgical and chronic wounds
Who was studied
Patients with chronic or postoperative wounds, including surgical and graft/flap wounds
What they received
Topical manuka honey applied to wounds
Compared with
No specific comparator stated; review of various studies
Main outcome
Wound healing outcomes such as bacterial load, healing speed and comfort
Quality
This is a narrative review without pooled data or control groups, and the authors themselves say high-quality surgical trials are still needed to confirm benefit.
Limitations
No systematic methodology or pooled statistics reported; does not focus specifically on anorectal surgery; calls for more robust trials.
Taken word for word from the abstract
- population Chronic and postoperative wounds remain challenging to manage, with high risks of infection, delayed healing and increased costs.
- intervention Manuka honey offers antibacterial, anti-inflammatory, antioxidant and tissue-regenerative properties through methylglyoxal, phenolic compounds, high sugar content and low pH.
- 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, prioritising randomised controlled trials and high-quality observational data.
- 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.
- qualityWhy 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
No difference from gelatin sponge.Randomised trialLow qualityRelated question
21 people14 days
No significant differences between honey dressing and gelatin sponge in pain, discomfort, burning sensation, or diet changes at 14 days; healing was rated very good in both groups
Who was studied
Patients undergoing dental gum graft surgery with a wound on the roof of the mouth (palate), not anorectal surgery
What they received
Manuka honey-based dressing applied to the wound
Compared with
Gelatin sponge dressing
Main outcome
Pain, discomfort, burning sensation, diet changes, and wound healing at 14 days
Quality
Very small study (21 patients) in a different type of wound (dental palate, not anorectal), so it gives weak and indirect evidence for the question asked.
Limitations
Small sample size; split-mouth design in dental surgery patients, not anorectal surgery patients; short 14-day follow-up.
Taken word for word from the abstract
- population A total of 21 patients (16 females and 5 males) with multiple gingival recessions (GR) were treated using the modified coronally advanced tunnel technique (MCAT) and subepithelial connective tissue graft (SCTG) following FGG de-epithelialization.
- intervention a non-adherent viscose net dressing coated with 99% Manuka honey and 1% Manuka oil
- comparator an absorbable hemostatic porcine gelatin sponge
- 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 In both the honey group and the gelatin sponge group, no significant differences were observed in postoperative pain, patient discomfort, burning sensation, or changes in dietary habits at 14 days postoperatively (p > 0.05).
- n A total of 21 patients (16 females and 5 males)
Adv Clin Exp Med · PMID 42087593 · Read it on PubMed ↗
Gupta 2026
Malignant Fungating Wounds in Advanced Cancer: Pathophysiology, Odor Control, and Dignity-Centered Management
Mentioned as emerging adjunct, not tested hereNarrative reviewVery low qualityRelated question
size not given2026
review states emerging evidence for manuka honey as a biofilm-disrupting adjunct for odor control, without reporting a specific trial result
Who was studied
patients with malignant fungating wounds from advanced cancer
What they received
topical manuka honey
Main outcome
wound odor control via biofilm disruption
Quality
this is a narrative review covering a different wound type (cancer-related fungating wounds, not surgical or anorectal wounds) and only briefly mentions manuka honey as an emerging adjunct without describing any specific study, population, or outcome data.
Limitations
no original data, no description of study design, population, or results for manuka honey specifically; covers malignant fungating wounds in cancer patients rather than surgical or anorectal wounds
Taken word for word from the abstract
- population Malignant fungating wounds (MFWs) represent a profoundly distressing complication of advanced cancer
- intervention emerging evidence for cadexomer iodine and Manuka honey as biofilm-disrupting adjuncts
- primaryOutcome evidence-based strategies for odor control and wound myiasis management
- result Topical metronidazole remains the most robustly supported intervention for odor control, with emerging evidence for cadexomer iodine and Manuka honey as biofilm-disrupting adjuncts.
Curr Oncol Rep · PMID 42071136 · 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 difference from other dressings.Randomised trialLow qualityRelated question
42 people2026
No significant difference between honey and the other dressings in wound closure overall, though for burns specifically the petroleum-based dressing did better than honey
Who was studied
Adults with acute wounds treated at two hospitals in southeast Nigeria
What they received
Honey applied to the wound (type of honey not specified as manuka)
Compared with
A petroleum-based cellulose dressing (Biodress) and separately povidone-iodine ointment
Main outcome
Whether the wound closed, plus complications, cost, ease of use
Quality
Very small trial (42 patients split three ways), single-blinded, and the honey used is not confirmed to be manuka honey or anorectal surgery patients.
Limitations
Small sample size, single-blinding only, general acute wound population rather than anorectal surgery patients, and the type of honey is not specified as manuka.
Taken word for word from the abstract
- population A single-blinded randomised controlled trial (RCT) was performed among patients with acute wounds selected from two hospitals in southeast Nigeria.
- intervention either honey or povidone-iodine which were used as two independent control groups
- comparator the petroleum-based dressing used as the intervention
- primaryOutcome To determine the effectiveness of Biodress (a petroleum-based hydrogen-calcium salt of oxidised cellulose dressing made of organic materials; Bottu, Morocco) against both honey and povidone-iodine ointment on wound closure, the incidence of wound complications, the cost of wound care, ease of use, and the outcome of acute wounds.
- 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).
- n A total of 42 patients were included in this RCT
J Wound Care · PMID 42068250 · 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, lower inflammation markers.Randomised trialVery low qualityRelated question
size not given2026
Honey supplementation showed comparable clinical outcomes to standard dressings, with greater reductions in inflammatory markers (IL-1, TNF-α) and increased VEGF expression
Who was studied
patients with deep neck abscess undergoing wound dressing
What they received
standard wound dressing plus honey
Compared with
standard wound dressing alone
Main outcome
wound size, wound assessment scores, pain scores, white blood cell count, bacterial growth, and inflammatory markers
Quality
The abstract does not report the number of participants, does not specify the type of honey used, and the condition studied (deep neck abscess) differs from the anorectal or general wound healing question, limiting how much this result can be trusted for that purpose.
Limitations
No participant number reported, single-blind design only, and honey type (whether manuka) is not specified.
Taken word for word from the abstract
- result Honey supplementation showed comparable clinical outcomes to standard dressings, demonstrated greater reductions in inflammatory markers (IL-1, TNF-α) and increased VEGF expression.
- primaryOutcome based on 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)
- intervention standard dressing supplemented with honey
- comparator standard wound dressing
- population patients with DNA
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’s effect not reported here.Meta-analysisLow qualityRelated question
1,292 people2026
The abstract reports that antibiotic bone cement and silver dressings outperformed standard care, but does not give a specific result for honey dressings versus standard care
Who was studied
people with diabetic foot ulcers
What they received
honey dressings (type not specified as manuka)
Compared with
standard care, silver dressings, and antibiotic-impregnated bone cement
Main outcome
wound healing rate, healing time, and wound area reduction
Quality
It pools several randomized trials but never reports honey dressings' own outcome data, so no clear conclusion about honey can be drawn from this abstract.
Limitations
Studies diabetic foot ulcers rather than surgical or anorectal wounds, does not specify manuka honey, and does not report honey's individual comparison results.
Taken word for word from the abstract
- population Antimicrobial dressings have been used to treat diabetic foot ulcers (DFU).
- 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 wound area reduction
- result The network meta-analysis revealed that 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 ↗
Dagher et al. 2026
A Prospective Randomised Clinical Study Comparing Polygalacturonic and Caprylic Acid Ointment to Medical-Grade Honey in the Management of Chronic Wounds
Honey healed fewer wounds than comparator.Randomised trialLow qualityRelated question
26 people6 weeks
All 13 PG-CAP patients showed improvement (100%), compared to only 69% of the 13 MediHoney patients (p = 0.023), with some honey-arm failures associated with death
Who was studied
patients with chronic full-thickness wounds
What they received
Medical-grade honey (MediHoney)
Compared with
Polygalacturonic-caprylic acid (PG-CAP) ointment
Main outcome
wound healing tracked with the Pressure Ulcer Scale for Healing (PUSH) score over 6 weeks
Quality
This was a very small trial (13 patients per arm), open-label, with an unequal rate of diabetes between groups, so the honey result carries limited weight.
Limitations
Small sample size, open-label (not blinded), baseline imbalance with more diabetes in the comparator group, and wounds were general chronic wounds rather than anorectal surgical wounds specifically.
Taken word for word from the abstract
- n Twenty-six patients with chronic wounds were included.
- population patients with chronic full-thickness wounds were randomised to daily treatment with PG-CAP ointment or MediHoney
- intervention MediHoney
- comparator polygalacturonic-caprylic acid (PG-CAP) ointment
- primaryOutcome The validated Pressure Ulcer Scale for Healing (PUSH) score was used to track healing.
- result All 13 PG-CAP patients showed improvement (100%), compared to only 69% of the 13 MediHoney patients (p = 0.023).
- result Half of the failures in the MediHoney arm were associated with death (15%).
Int Wound J · PMID 41574641 · Read it on PubMed ↗
Sukarni et al. 2026
Relationship between microbiota and healing status in diabetes-related foot ulcers treated with Trigona honey
Honey alone may not be enough.Prospective cohortVery low qualityRelated question
12 people1 week
Certain bacteria (like Enterococcus and Corynebacterium) differed between healing and deteriorating ulcers, and the authors concluded honey alone may not be enough to treat these ulcers
Who was studied
Patients with diabetes-related foot ulcers
What they received
Trigona honey applied to the wound
Compared with
No comparator group; wounds classified as healing vs deteriorating
Main outcome
Relationship between wound/peri-wound bacteria (microbiota) and whether the ulcer was healing or getting worse
Quality
Only 12 wounds were studied for just one week, with no control group, so the findings are too limited to judge whether the honey worked.
Limitations
Small sample size and short follow-up period, as stated by the authors; no comparator treatment group.
Taken word for word from the abstract
- population Diabetes-related foot ulcers (DFUs) are a major complication of diabetes
- intervention treated with Trigona honey
- comparator categorized into healing and deteriorating groups
- primaryOutcome investigate the relationship between the microbiota and the healing status in DFUs treated with Trigona honey
- result These results also imply that honey therapy on its own may not be enough for treating DFUs.
- n A cohort study involving 12 DFUs categorized into healing and deteriorating groups was conducted.
J Tissue Viability · PMID 41443129 · Read it on PubMed ↗
Gallagher et al. 2024
Expediting acute wound healing by integrating multiple therapeutic strategies: a case series
Can't tell honey's own effectCase seriesVery low qualityRelated question
124 people2024
median healing time was 19 days using the multimodal combination therapy that sometimes included manuka honey
Who was studied
patients with acute traumatic wounds needing specialist wound care
What they received
manuka honey used as part of a multi-product wound care combination (along with hypochlorous acid cleanser, negative pressure therapy, collagen, silver, and foam dressings)
Compared with
no comparison group; all patients received combination therapy
Main outcome
time to wound healing
Quality
this is a small case series with no control group and no way to tell what manuka honey itself contributed, since it was just one of several products used together.
Limitations
No isolation of manuka honey's effect from the other treatments used together; no comparator group; not specific to anorectal surgery; wounds were general acute traumatic wounds, not surgical anorectal wounds.
Taken word for word from the abstract
- 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 A total of 124 patients with acute wounds up to 1120 cm3 healed using multimodal therapy.
- primaryOutcome Key outcomes included wound progression, dimensions, treatments, healing time, and health care utilization metrics.
- result Median healing time was 19 days.
- n A total of 124 patients with acute wounds up to 1120 cm3 healed using multimodal therapy.
Wound Manag Prev · PMID 39788879 · Read it on PubMed ↗
Kheradvar Kolour et al. 2024
Janus Films Wound Dressing Comprising Electrospun Gelatin/PCL Nanofibers and Gelatin/Honey/Curcumin Thawed Layer
Faster healing with honey-curcumin dressingAnimal studyLow 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 animal model (species not specified)
What they received
bilayered wound dressing with gelatin/PCL nanofiber layer plus a gelatin/honey/curcumin hydrogel layer
Compared with
a commercial wound dressing
Main outcome
wound healing measures (wound closure, collagen production, tissue granulation, re-epithelialization)
Quality
this is a small animal study of a combined honey-curcumin-gelatin scaffold with no sample size given, so it can't show whether honey itself, rather than the whole material, caused the effect.
Limitations
Animal (in vivo) study only, no participant numbers reported, honey is combined with curcumin and a synthetic nanofiber scaffold rather than tested alone, honey type (manuka or otherwise) not specified, and no human or anorectal surgery wounds were studied.
Taken word for word from the abstract
- population to treat wounds under an in vivo study
- 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
ACS Appl Bio Mater · PMID 39676562 · Read it on PubMed ↗
Zhang et al. 2024
Autologous platelet-rich fibrin enhances skin wound healing in a feline trauma model
Comparable healing to PRF in catsAnimal studyLow qualityRelated question
18 people28 days
The manuka honey group's wound healing outcomes were comparable to the PRF group, both apparently better than untreated control based on study design
Who was studied
Cats with experimentally created skin trauma wounds (animal model, not human surgical patients)
What they received
Topical manuka honey applied to the wound (used as a positive control)
Compared with
Untreated control group and platelet-rich fibrin (PRF) treated group
Main outcome
Rate and quality of skin wound healing (healing rate, histology, growth factors, collagen formation)
Quality
This is a small animal (cat) study with only six animals per group, testing an experimental trauma model rather than human surgical or anorectal wounds.
Limitations
Animal model (cats) with small group sizes, trauma-induced wounds rather than human surgical or anorectal wounds, and honey used only as a secondary 'positive control' rather than the main focus of the study.
Taken word for word from the abstract
- population The models of feline trauma were effectively established.
- intervention Manuka honey group (MAN, as a positive control)
- comparator Control group (CON); (2) PRF group; (3) Manuka honey group
- primaryOutcome PRF accelerated skin wound healing in the cat trauma model based on the rate and histological observation of wound healing.
- 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)
BMC Vet Res · PMID 39508248 · 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 test only, not in patientsLaboratory studyVery low qualityRelated question
size not given2024
The coated membranes were biocompatible with fibroblasts, showed expression of healing-related genes, and had strong antibacterial activity, especially when cinnamon essential oil was added
Who was studied
Laboratory study using fibroblast cells and bacterial strains, not human patients
What they received
Manuka honey combined with essential oil nanoemulsions coated onto polycaprolactone (PCL) membranes using layer-by-layer chitosan coating
Compared with
Different coating compositions of the membranes (not a human comparator)
Main outcome
Biocompatibility, expression of wound-healing related genes (VEGF, COL1, TGF-β1), and antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa
Quality
This is a lab-based material science study using cells and bacteria in dishes, not real patients or wounds, so it cannot show whether manuka honey actually helps people heal.
Limitations
No human or animal wound testing; manuka honey is combined with essential oils and chitosan coatings rather than tested alone; outcomes are cell gene expression and bacterial inhibition, not actual wound healing in a person.
Taken word for word from the abstract
- population The coated membranes were tested in the presence of fibroblast cells, demonstrating biocompatibility
- intervention a mixture of manuka honey with essential oils nanoemulsions as a polyanion
- comparator FTIR-ATR and XPS analyses distinguished among different coating compositions
- primaryOutcome 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
Fast healing, but no comparison.Case seriesVery low qualityRelated question
25 people2024
all women had no wound induration or separation, 13% had wound discharge, and wounds healed in about 2.2 days on average
Who was studied
women who had caesarean section wounds in Uganda
What they received
a dressing made of honey and olive oil (I-Dress)
Compared with
none (single-group case series, no comparison dressing)
Main outcome
time 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 standard care.
Limitations
no control group, small sample size, single-arm design, and the intervention was a honey-olive oil combination rather than manuka honey alone, in caesarean wounds rather than anorectal surgery wounds
Taken word for word from the abstract
- population 25 women who received I-Dress following caesarean births at three health facilities in south-west Uganda
- intervention 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
- 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.
- n A case-series study was conducted on 25 women
Int Wound J · PMID 39211979 · 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
No real difference versus povidone-iodine.Randomised trialLow qualityRelated question
35 people2024
No statistically significant difference in healing time between honey, povidone-iodine and paraffin groups, though more honey-treated wounds healed within 10 days and cost was lowest
Who was studied
patients with acute laceration wounds (mostly young, rural Indonesia)
What they received
topical honey dressing
Compared with
povidone-iodine or paraffin gauze dressing
Main outcome
time for the wound to heal
Quality
This was a very small pilot trial with only 35 patients, it did not specify manuka honey, and it studied general cuts rather than anorectal surgery wounds.
Limitations
Small pilot sample size, single-blind design, wound type not anorectal surgery, honey type not specified as manuka, one patient lost to follow-up.
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
- 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 ↗
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
May speed healing, but wrong wound typeMeta-analysisLow qualityRelated question
size not givenat least 12 weeks
advanced dressings as a group showed higher healing rate that was not statistically significant, but significantly shorter time to healing; the authors' conclusion singles out honey dressings (along with others) as promoting healing
Who was studied
people with diabetic foot ulcers (not anorectal surgery wounds)
What they received
advanced wound dressings as a group, including honey-impregnated dressings (not specified as manuka honey, not isolated from other dressing types)
Compared with
standard of care or placebo dressing
Main outcome
rate of ulcer healing
Quality
this is a meta-analysis of a different population (diabetic foot ulcers, not anorectal surgical wounds) that pools many different dressing types together, so the specific effect of manuka honey cannot be isolated from this abstract.
Limitations
honey dressings are not isolated as their own comparison group in the reported statistics, the population is diabetic foot ulcers rather than surgical/anorectal wounds, and it is not stated that the honey used was manuka honey.
Taken word for word from the abstract
- population collecting all RCTs including diabetic patients or reporting subgroup analyses on diabetic patients with DFU comparing AWD with placebo/standard of care
- intervention honey-impregnated
- comparator comparing AWD with placebo/standard of care (SoC)
- primaryOutcome Prespecified endpoints were: ulcer healing (principal)
- 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).
- result AWD, particularly sucrose-octasulfate, hydrogels, hyaluronic acid, and honey dressings, can actively promote wound healing and shortening time-to-healing in patients with DFU.
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 healing, but wrong honey/speciesAnimal studyVery low qualityRelated question
56 people2023
Rats given Trigona honey twice daily healed fastest (by day 9), faster than turmeric gel groups and the untreated control
Who was studied
female rats recovering from cesarean section wounds
What they received
Trigona honey applied to the wound
Compared with
turmeric extract gel (50% and 75%) and untreated control group
Main outcome
speed of wound healing measured by redness, swelling, and tissue formation (Reeda Scale)
Quality
This is a small animal (rat) study using a different honey type (Trigona, not manuka) on cesarean wounds, not surgical wounds in humans, so it gives very weak evidence for the question asked.
Limitations
Animal study only, used Trigona honey rather than manuka honey, examined cesarean section skin wounds rather than anorectal surgical wounds, and is described by the authors as preliminary.
Taken word for word from the abstract
- population Female white rats ( Rattus novergicus) with pre- and post-testing and a control group were included in this experiment
- intervention original Trigona honey
- comparator 50% and 75% turmeric extract gel
- 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.
- n The test animals were 56 female white rats, 2-4 months old, weighing 150-350 g.
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
Honey sped healing of foot ulcersRandomised trialLow qualityRelated question
120 people2026
Average healing time was 12.20 days with honey alone, 13.97 days with hydrogel alone, 10.83 days with honey and hydrogel alternated, and 14.03 days with fucidin ointment/cream (p = 0.04)
Who was studied
People with type 2 diabetes and second-degree diabetic foot ulcers
What they received
Topical honey (type not specified as manuka), alone or alternated with hydrogel
Compared with
Fucidin (antibiotic) ointment or cream, or hydrogel alone
Main outcome
Time for the wound to fully heal
Quality
It was a randomized trial but only single-blinded, had small groups of 30 patients each, and did not confirm the honey used was manuka honey.
Limitations
Single-blinded design, small group sizes, honey type not specified as manuka, and population is diabetic foot ulcers rather than anorectal surgical wounds.
Taken word for word from the abstract
- population diabetic mellitus type 2 patients with ulcer in their second-degree feet
- intervention honey alone, hydrogel alone, honey, and hydrogel combination alternately
- 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)]
- n This study involved 120 patients
Int J Low Extrem Wounds · PMID 38425229 · Read it on PubMed ↗
Wei et al. 2024
Transparent injectable sericin-honey hydrogel with antioxidant and antibacterial activities combined with feeding sericin accelerates diabetic wound healing
Faster wound healing in diabetic miceAnimal studyVery low qualityRelated question
size not given2024
The sericin-honey hydrogel significantly accelerated the wound healing process in diabetic mice
Who was studied
Diabetic mice with wounds
What they received
Sericin-honey hydrogel (honey combined with sericin protein) applied to wound, plus oral sericin feeding
Main outcome
Speed of wound healing in diabetic mice
Quality
This is an early-stage animal (mouse) study of a honey-sericin composite material, not manuka honey alone, and gives no human or anorectal surgery data.
Limitations
Only tested in a mouse model; honey is combined with sericin and not tested alone; no comparator group described; no human wound or anorectal surgery data; no mention of manuka honey specifically.
Taken word for word from the abstract
- population a mouse diabetic wound model
- intervention a sericin-honey semi-interpenetrating network hydrogel with excellent antioxidant activity was prepared
- primaryOutcome significantly accelerating the wound healing process
- result significantly accelerating the wound healing process
Biomed Mater · PMID 38422522 · Read it on PubMed ↗
Xu et al. 2026
Effectiveness of APG and Honey Gauze in Pressure Injury of Elderly: A Randomized Control Trial
Honey plus platelet gel aided healingRandomised trialLow qualityRelated question
42 people2026
The combination of honey gauze plus platelet gel group showed significantly more granulation tissue coverage and a bigger drop in PUSH score than other groups; results for honey gauze used alone were not separately reported
Who was studied
Elderly patients with stage 3-4 pressure injuries (bedsores), not surgical wounds
What they received
Manuka honey gauze, alone or combined with platelet-rich plasma gel (APG)
Compared with
Platelet-rich plasma gel alone or standard control treatment
Main outcome
Wound bed coverage with new tissue and change in Pressure Ulcer Scale for Healing (PUSH) score
Quality
Small study (42 patients split across four groups) looking at pressure sores rather than surgical wounds, and it does not report how manuka honey alone performed compared to the control.
Limitations
Small sample size split across four treatment arms, no separate data given for honey-only group, and population is pressure ulcers rather than anorectal surgical wounds.
Taken word for word from the abstract
- population treatment of Stages 3-4 pressure injury of older adults
- intervention Manuka honey gauze and APG (M + A), Manuka honey gauze (M)
- comparator APG (A), and a control group (C)
- primaryOutcome wound bed coverage with granulation tissue, wound size reduction, and Pressure Ulcer Scale for Healing (PUSH) score
- result Significant increase of wound bed coverage with granulation tissue (51.24%, P = .004, Kruskal-Wallis test) and decrease of PUSH score (-5) were observed in the M + A group
- n A total of 42 patients were accepted.
Int J Low Extrem Wounds · PMID 38403980 · Read it on PubMed ↗
Suryadinata et al. 2024
Honey dressing for penile skin avulsion caused by traditional circumcision: a case report
Wound healed but left scarring.Case seriesVery low qualityRelated question
1 people43 days
the wound fully re-epithelialised by day 43, but the patient was left with reduced sexual function and poor appearance due to scar contracture because he declined skin-graft surgery
Who was studied
young man with complete skin loss of the penis after traditional circumcision
What they received
honey dressing (Indonesian honey, not specified as manuka) applied to the wound
Compared with
none - single patient case report, no comparison group
Main outcome
wound healing of the contaminated, degloved penile wound
Quality
this is a single patient with no comparison group, so it cannot show whether honey worked better than any other treatment.
Limitations
single case report with no control group, the honey used was not identified as manuka honey, and the wound was a penile degloving injury rather than anorectal surgery.
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 CASE: A 24-year-old male patient with penile bleeding presented to the emergency department after undergoing traditional circumcision.
- primaryOutcome We aimed to present the use of honey dressing and the benefit of its wound healing properties for management of such a complex wound.
- result A complete re-epithelialisation of the wound was achieved without progression to the hard-to-heal state by day 43. Suboptimal sexual function and aesthetic result due to wound contracture were observed as surgical reconstruction via split-thickness skin graft was refused due to cost.
- n A 24-year-old male patient with penile bleeding presented to the emergency department
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 healing in animal wounds (combo dressing)Animal studyVery low qualityRelated question
size not given7 days (for VEGF release); exact wound healing follow-up duration not stated
The combined honey-keratin-VEGF bilayer dressing healed wounds faster than other groups tested
Who was studied
Animals with full-thickness skin wounds (lab/animal model, not human anorectal surgery patients)
What they received
A bilayer wound dressing combining honey, keratin, PAAc polymer, and VEGF growth factor
Compared with
Other dressing groups (not specified which)
Main outcome
Speed and quality of wound healing (blood vessel formation, collagen, epidermal regeneration)
Quality
This is an animal/lab study of a complex multi-ingredient dressing, not a human trial of manuka honey alone, so it cannot show whether manuka honey itself helps wounds in people.
Limitations
Animal model only, not human patients; honey is combined with keratin, PAAc, and VEGF so its individual contribution cannot be isolated; manuka honey is not specifically named or tested; not related to anorectal surgery.
Taken word for word from the abstract
- population 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.
- intervention Hydrophilic poly(acrylic acid) (PAAc)-honey (Hny) with interconnected pores of 76.04 μm was prepared as the TL and keratin (Kr), Hny, and vascular endothelial growth factor (VEGF) were prepared as the BL.
- comparator the full-thickness wound healed faster when it was covered with PAAc-Hny/Hny-Kr-VEGF than in other groups
- primaryOutcome Additionally, faster blood vessel formation, collagen synthetization, and epidermal layer generation were also confirmed, which have proven efficient healing acceleration in wounds treated with synthesized bilayer dressings.
- 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
Less effective than aloe vera.Animal studyVery low qualityRelated question
size not given2026
Aloe vera reduced wound diameter more than honey and the control group, but honey's effect versus control was not separately reported
Who was studied
Mice with full-thickness skin wounds
What they received
Topical honey (type unspecified)
Compared with
Aloe vera and hydrocolloid dressing (control)
Main outcome
Wound diameter/healing progress
Quality
It is a small animal study with no reported sample size, uses honey of unspecified type (not confirmed manuka), and does not directly compare honey to control.
Limitations
Animal (mouse) model, honey type not specified as manuka, no human or anorectal surgery data, sample size not reported.
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
- comparator versus hydrocolloid (HC) dressings as a control group
- primaryOutcome reduced the diameter of the 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 ↗
Alihosseini et al. 2023
Do Commonly Used Antimicrobial Topicals Facilitate Venous Leg Ulcer Healing?
No specific result for honey reportedNarrative reviewLow qualityRelated question
size not given2023
the review concludes that several different topical antimicrobials can help, with no specific finding reported for manuka honey alone
Who was studied
people with chronic venous leg ulcers (not specifically anorectal surgery wounds)
What they received
various topical antimicrobial agents (manuka honey is only one of many discussed)
Main outcome
healing of venous leg ulcers
Quality
it is a narrative review mixing randomized trials with lower-quality case series, searched only a few databases, and gives no distinct data on manuka honey's effect.
Limitations
review of venous leg ulcer patients, not anorectal surgery patients; included studies vary greatly in design and quality; no pooled statistics given
Taken word for word from the abstract
- population To survey which topical antimicrobials are most helpful in treating venous leg ulcers (VLUs).
- intervention Exceptions to this were in vitro studies of manuka honey and Dakin solution (Century Pharmaceuticals).
- primaryOutcome Studies were eligible for inclusion if they studied the effects of antimicrobial agents on chronic VLU healing
- result Studies suggest that VLUs can be treated with multiple different topical antimicrobials. Depending on the extent of chronicity and bacterial colonization, some antimicrobials may be better suited than others.
Adv Skin Wound Care · PMID 37212566 · Read it on PubMed ↗
Salrian et al. 2022
Amplification of Wound Healing by Propolis and Honey Ointment in Healthy and Diabetic Rat Models; Histopathological and Morphometric Findings
Faster healing with honey-propolis mix in ratsAnimal studyVery low qualityRelated question
80 people14 days
Significant healing quality and acceleration were seen with propolis and honey combination compared to other subgroups on days 3 and 5
Who was studied
Healthy and diabetic rats with surgically created skin wounds
What they received
Topical ointment containing propolis and honey (combination), compared with honey+eucerit alone in another subgroup
Compared with
Saline-only control and eucerit ointment alone
Main outcome
Wound healing measured by wound contraction, granulation tissue, fibroblasts, re-epithelization and angiogenesis on days 1,3,5,7 and 14
Quality
This is a small animal study using a honey-propolis combination rather than manuka honey alone, so it cannot show whether honey by itself helps human wounds.
Limitations
Animal (rat) model, not human; honey was combined with propolis in the main treatment group rather than tested alone; type of honey used is not stated as manuka; no anorectal or surgical human wounds studied.
Taken word for word from the abstract
- n The 7 mm full-thickness skin wounds were created on the abdomen region in 80 male Wistar rats using paunch.
- population rats were randomly allocated into two healthy and diabetic groups
- intervention dressed with Eucerit, 1.5% honey+eucerit, and 3% propolis +1.5% honey+eucerit, once daily for 14 days
- comparator the wounds were cleaned with normal 0.9% saline as the control subgroup
- primaryOutcome the granulation tissue, fibroblasts, re-epithelization, and angiogenesis increased (P≤0.05) in the subgroups treated by propolis and honey combination
- result significant healing quality and acceleration were affected by propolis and honey compared to other subgroups on days 3 and 5 (P≤0.05)
Arch Razi Inst · PMID 37123150 · Read it on PubMed ↗
Yildiz Karadeniz et al. 2023
Use of honey in diabetic foot ulcer: Systematic review and meta-analysis
Faster healing in diabetic foot ulcersMeta-analysisLow qualityRelated question
size not given2023
honey dressing reduced wound recovery time, pain, and hospital stay, and sped up granulation tissue formation
Who was studied
people with diabetic foot ulcers
What they received
honey dressing on the wound
Compared with
usual wound care (comparator not specified in abstract)
Main outcome
wound healing time, pain, hospital stay, and granulation tissue formation
Quality
The pooled studies mixed randomized trials with weaker quasi-experimental and observational designs, and the abstract gives no numbers on how many patients or studies were included.
Limitations
Abstract does not specify honey type (not confirmed as manuka), does not report sample size, and pools different study designs together.
Taken word for word from the abstract
- population diabetic foot wound management
- intervention honey dressing
- primaryOutcome reduces wound recovery time and rate, incurred pain, hospital stay, and accelerates granulation in DFU wounds
- result The meta-analysis showed that honey used effectively reduces wound recovery time and rate, incurred pain, hospital stay, and accelerates granulation in DFU wounds.
- comparator 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 with honey on diabetic foot ulcersMeta-analysisVery low qualityRelated question
882 people2023
Honey dressing group had a higher wound healing rate and shorter healing time than the control group
Who was studied
People with diabetic foot ulcers
What they received
Honey dressing applied to the wound (type of honey not specified as manuka)
Compared with
Standard wound care control
Main outcome
Wound healing rate and time to healing
Quality
This meta-analysis is listed as a retracted publication and the authors themselves warn that most included studies had low sample sizes, so its findings cannot be trusted.
Limitations
The abstract does not specify manuka honey, studies this is a retracted publication, and most included studies had low sample sizes as noted by the authors themselves.
Taken word for word from the abstract
- population 882 subjects with DFUs were in the picked studies' baseline
- intervention honey dressing (HD) in the management of diabetic foot ulcer (DFU)
- comparator 458 were using a control
- primaryOutcome 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)
- 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.
- n The picked studies contained 882 subjects with DFUs were in the picked studies' baseline
Int Wound J · PMID 36994798 · Read it on PubMed ↗
Ouchi et al. 2023
Topical Intervention of Natural Products Applied in Patients with Pressure Injuries: A Scoping Review
Honey helped pressure sores heal (not surgery wounds)Systematic reviewLow qualityRelated question
size not given2023
Honey dressings were one of the natural products that significantly reduced wound size
Who was studied
people with pressure injuries (bedsores)
What they received
topical honey dressings (type of honey not specified as manuka)
Compared with
other control wound treatments
Main outcome
wound healing or reduction in wound size
Quality
This is a scoping review of only six small trials on pressure injuries, not surgical wounds, and does not specify manuka honey or anorectal surgery patients.
Limitations
Abstract states there are limited controlled clinical trials on natural products and pressure injuries; studies are on pressure injuries, not surgical or anorectal wounds, and honey type is not specified as manuka.
Taken word for word from the abstract
- population individuals with PIs
- intervention Honey and Plantago major dressings were the topical interventions that significantly reduced wound size.
- comparator individuals treated with topical natural products compared to a control treatment
- primaryOutcome outcomes with wound healing or wound reduction were included in this review
- result Honey and Plantago major dressings were the topical interventions that significantly reduced wound size.
Adv Skin Wound Care · PMID 36812084 · Read it on PubMed ↗
Rodríguez et al. 2023
Novel bioengineered collagen with Manuka honey and hydroxyapatite sheet for the treatment of lower extremity chronic wounds in an urban hospital wound care setting
Faster closure, but only in combination productRetrospectiveLow qualityRelated question
47 people2023
Among wounds that closed, average time to closure was about twice as fast with the BCMH sheet than standard care (7.4 weeks vs 14.8 weeks); most wounds in both groups did not close at all
Who was studied
Adults with chronic lower extremity wounds at an urban hospital wound clinic
What they received
A bioengineered sheet combining collagen, Manuka honey, and hydroxyapatite (BCMH)
Compared with
Standard of care wound treatments (various products/therapies)
Main outcome
Time until the wound closed
Quality
This was a small retrospective chart review of a combination product (not honey alone), comparing it to varied standard-of-care treatments, and most wounds in both groups never actually closed.
Limitations
Retrospective design, small sample, standard-of-care group used mixed/varied treatments, and the tested product combines honey with collagen and hydroxyapatite rather than testing manuka honey alone; wound location was lower extremity chronic wounds, not anorectal surgical wounds.
Taken word for word from the abstract
- population This retrospective evaluation assessed chronic wound closure rates with SOC or treatment with the BCMH sheet in an urban hospital wound clinic.
- intervention 27 wounds were treated with the BCMH sheet
- comparator Twenty wounds were treated with SOC, which varied in usage of multiple products and/or therapies
- primaryOutcome The primary endpoint was time to closure.
- n Forty-seven chronic wounds were treated with SOC or the BCMH sheet.
- result In both groups, most wounds that were treated did not close. For wounds that did close, the average time to closure was 2x faster in the BCMH group compared with the SOC group (7.4 weeks and 14.8 weeks, respectively; P < .05).
Wounds · PMID 36749996 · Read it on PubMed ↗
Brites et al. 2023
Fabrication of antibacterial and biocompatible 3D printed Manuka-Gelatin based patch for wound healing applications
Lab test only, not tested in peopleLaboratory studyVery low qualityRelated question
size not given2023
The patch killed common wound bacteria and increased growth of skin cells and blood vessel formation in lab tests
Who was studied
Not applicable - this is a laboratory study using cells and bacteria, not patients
What they received
3D printed patch made of Manuka honey combined with gelatin hydrogel
Main outcome
Antibacterial activity and effects on skin cell growth and blood vessel formation in lab tests
Quality
This is a laboratory experiment on cells and bacteria, not a study in patients, so it cannot show whether this helps real wounds heal.
Limitations
In vitro lab study only; no human or animal wound testing; no patients or clinical wounds involved
Taken word for word from the abstract
- intervention an antibacterial Manuka-Gelatin 3D patches was developed by an extrusion-based printing process, with controlled porosity, high shape fidelity, and structural stability
- primaryOutcome It was demonstrated the antibacterial activity of Manuka-Gelatin 3D patches against both gram-positive bacteria (S. epidermidis and S. aureus) and gram-negative (E. coli), common in wound infection
- result The 3D Manuka-Gelatin base patches demonstrated antibacterial activity, and moreover enhanced the proliferation of human dermal fibroblasts and human epidermal keratinocytes, and promotion of angiogenesis
- population enhanced the proliferation of human dermal fibroblasts and human epidermal keratinocytes
Int J Pharm · PMID 36566824 · Read it on PubMed ↗
Askari et al. 2025
Bentonite Nanoparticles and Honey Co-Administration Effects on Skin Wound Healing: Experimental Study in the BALB/c MICE
Honey boosted nanoparticle wound healing in miceAnimal studyLow qualityRelated question
60 people14 days
Honey combined with bentonite nanoparticles improved wound healing measures more than nanoparticles alone; honey acted as a synergistic solvent
Who was studied
Adult male BALB/c mice with surgically made skin wounds on their backs
What they received
Honey (not specified as manuka) applied topically, alone or combined with bentonite nanoparticles
Compared with
Untreated control, polyethylene glycol, or nanoparticles dissolved in polyethylene glycol
Main outcome
Microscopic wound healing measures: inflammation, fibroblast growth, new skin formation, granulation tissue and collagen fibers
Quality
This is a small animal experiment using mice, not humans, and the honey type is not identified as manuka, so it only weakly applies to the human wound-healing question.
Limitations
Animal study only, honey type not specified as manuka, honey was tested mainly as a solvent for nanoparticles rather than alone, no anorectal surgery patients involved.
Taken word for word from the abstract
- population In this experimental study, an excisional wound injury model was developed in adult male BALB/c mice (n = 60) by creative two equal-sized wounds (5 mm) on either side of their back midline.
- intervention The animals were allocated into five groups (n = 12 each) as untreated control (U), honey (H), polyethylene glycol (P), and (BNPs) dissolved in honey or polyethylene glycol (H + BNPs, P + BNPs).
- comparator The animals were allocated into five groups (n = 12 each) as untreated control (U), honey (H), polyethylene glycol (P), and (BNPs) dissolved in honey or polyethylene glycol (H + BNPs, P + BNPs).
- primaryOutcome The histomorphological parameters including inflammatory cells infiltration, fibroblasts, re-epithelialization, granulation formation, and collagenases were evaluated in all tissue sections.
- result Compared to the control group, BNPs showed significant wound healing activities with lower inflammatory cells infiltration, higher fibroblastosis and new epithelium thickness, and greater granulation area and collagen fibers density in the ulcer bed.
- result In addition, honey as a solvent synergistically increased the wound healing activity of the studied nanoparticle.
- n In this experimental study, an excisional wound injury model was developed in adult male BALB/c mice (n = 60) by creative two equal-sized wounds (5 mm) on either side of their back midline.
Int J Low Extrem Wounds · PMID 35950795 · 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 eventually healed.Case seriesVery low qualityRelated question
1 people10 months
The wound healed after 6 months of dressing changes combining honey with silver ion dressings, and had not reopened after 10 months of follow-up
Who was studied
A 13-year-old girl with a chronic non-healing scalp wound after brain surgery
What they received
Honey combined with silver ion dressing applied to the wound
Compared with
None - single patient followed over time with prior dressing changes and debridement that had failed
Main outcome
Whether the chronic wound healed
Quality
This is a single patient case report with no comparison group, so it cannot show whether honey itself caused the healing.
Limitations
Single case, honey was combined with silver ion dressing rather than used alone, honey type is not specified as manuka, and the wound is a scalp surgical wound rather than an anorectal surgical wound.
Taken word for word from the abstract
- population 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 wound finally healed after 6 months of dressing changes by combining honey with silver ion dressings, and the incision had not re-ruptured after 10 months of follow-up
- n a 13-year-old female patient
Eur Rev Med Pharmacol Sci · PMID 35916823 · Read it on PubMed ↗
Virador et al. 2022
Systematically Assessing Natural Compounds' Wound Healing Potential with Spheroid and Scratch Assays
Helped cells heal in lab dishLaboratory studyVery low qualityRelated question
size not given2022
Manuka honey supported spheroid health and viability, and helped close wounds in scratch assays with less collagen production and more cell coverage
Who was studied
Not applicable (cell culture models, not patients)
What they received
Manuka honey applied to cell spheroids and cell cultures
Compared with
Untreated cells or hydrogen peroxide-damaged cells
Main outcome
Cell growth, viability, and wound closure in lab-grown cell models
Quality
This is a cell culture (in vitro) study, not a study in patients, so it cannot show whether manuka honey helps real wounds heal.
Limitations
Laboratory cell and spheroid models only, no human or animal wounds tested, described as a teaching/standardization tool for undergraduate research
Taken word for word from the abstract
- population The first model is a scaffold-free three-dimensional (3D) spheroid model
- intervention Our workflow gives insights into candidate compounds for wound healing as we show using manuka honey (MH) as an example.
- comparator Spheroids are responsive to oxidative damage by hydrogen peroxide (H2O2) which affects viability but mostly produces disaggregation.
- primaryOutcome it analyzes changes to the coverage of the wound edge and wound bed
- result Conversely, MH supports spheroid health, shown by size measurements and viability. In two-dimensional scratch wound assays, MH helps close wounds with relative less collagen production and increases the loose cellular coverage adjacent to and within the wound.
Adv Exp Med Biol · PMID 35882775 · 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, less infected.Case seriesVery low qualityRelated question
6 people2022
wounds started healing, infection was controlled, and pain, odour and exudate quickly improved
Who was studied
patients with hard-to-heal wounds, many with infections and other health problems
What they received
medical grade honey (MGH)-based wound care products applied to the wound
Compared with
no comparison group; used alone or alongside other treatments
Main outcome
wound healing, infection control, and quality of life (pain, odour, exudate)
Quality
This is a tiny report of just six patients with no comparison group, so it cannot show whether honey caused the improvement.
Limitations
No control group, very small number of patients, and the honey used was not specified as manuka honey nor was it tested after anorectal surgery.
Taken word for word from the abstract
- n we have described six cases of hard-to-heal wounds
- population Hard-to-heal wounds can be caused by persistent infections or an excess of inflammatory cytokines, proteases and oxidants
- 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 either as monotherapy or as a complementary therapy
- primaryOutcome 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 ↗
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
Honey dressing healed wounds faster.Randomised trialLow qualityRelated question
20 people4 weeks
Healing percentage was significantly higher with honey dressing at both 1 week (56% vs 44%) and 4 weeks (86-91% vs 9-14%), p=0.001
Who was studied
patients who had a gum graft taken from the roof of their mouth
What they received
honey dressing (Medihoney) applied to the wound site
Compared with
no dressing applied to the wound
Main outcome
percentage of wound healing (width and length of donor site) at 1 and 4 weeks
Quality
Very small study (10 patients per group) in a single center, not blinded, and measuring a surrogate wound-size outcome rather than clinical complications.
Limitations
Small sample size, unclear blinding, measures only wound size not broader healing complications, and the honey product's manuka content is not specified.
Taken word for word from the abstract
- population patients with 10 patients in each group
- 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 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)
- n a sample of 20 patients with 10 patients in each group
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
General review says honey aids healing.Narrative reviewVery low qualityRelated question
size not given2022
The review states that honey consistently showed beneficial effects, reducing inflammation and wound dehiscence and inducing healing, epithelialization, and analgesic activity across multiple non-traditional uses
Who was studied
Patients with wounds and other conditions such as post-surgery sites, tooth extraction sockets, and mucositis, not specifically anorectal surgery patients
What they received
Topical, subcutaneous, intra-socket, abdominal, or oral honey (not specified as manuka honey)
Compared with
No specific comparator reported; review summarizes multiple studies
Main outcome
Wound healing, infection prevention, inflammation, and dehiscence across various non-conventional uses of honey
Quality
This is a narrative review discussing mechanisms and various studies without systematic methodology, specific patient numbers, or focus on manuka honey or anorectal surgery, so it cannot reliably answer the specific question.
Limitations
No sample size, no systematic methodology described, honey type not specified as manuka, and no anorectal surgery population specifically addressed; focuses on molecular mechanisms rather than clinical trial outcomes.
Taken word for word from the abstract
- 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.
- 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
- comparator The current review provides an in-depth view of studies using honey outside the conventional wound care indications.
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 with honeyRandomised trialLow qualityRelated question
50 people4 weeks
At 2 weeks, significantly more wounds had fully healed in the honey group than the saline group, but by 4 weeks all wounds in both groups had healed
Who was studied
patients having cleft palate repair surgery (palatoplasty)
What they received
honey drops applied to the surgical wound in the mouth
Compared with
warm saline mouth rinse
Main outcome
how quickly the surgical wound in the palate healed over (re-epithelisation) at 2 and 4 weeks
Quality
This was a small single-centre trial of only 50 people with a different type of wound (mouth/palate surgery), so it carries limited weight for the anorectal wound question.
Limitations
Small sample size, single institution, and the honey type was not specified as manuka; the wound type (oral palatal surgery) differs from anorectal surgical wounds.
Taken word for word from the abstract
- population This was a prospective randomized study on participants with non-syndromic cleft palate conducted at a tertiary health institution in Lagos, Nigeria.
- 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.
- n Fifty participants were recruited into the study, 24 in the Test group and 26 in the Control 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
Infected wound healed with honey dressingCase seriesVery low qualityRelated question
1 people3 months
The wound was completely healed after three months of honey dressing treatment
Who was studied
Newborn baby with an infected surgical wound after removal of a tailbone tumor (not anorectal surgery)
What they received
Honey-containing antibacterial wound dressing (Medihoney) applied to the infected wound
Compared with
Previous treatment with saline dressings and intravenous antibiotics
Main outcome
Whether the surgical site infection healed
Quality
This is a single infant case report with no control group, so it cannot show whether honey caused the healing.
Limitations
Single case, no comparison group, wound type and patient population differ from anorectal surgery, and the honey is not specifically identified as manuka honey.
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
- population a surgeon removed a sacrococcygeal teratoma
- intervention an antibacterial wound dressing containing honey (Medihoney) on the SSI twice a day for a month
- comparator despite him receiving routine normal saline dressings twice a day and intravenous antibiotic therapy
- primaryOutcome The surgical site became infected, and the infection failed to improve
- 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 ↗
Askari et al. 2024
Wound Healing Effects of Chitosan Nanosheets/Honey Compounds in Male BALB/c Mice
Honey mixture helped wound healing in miceAnimal studyVery low qualityRelated question
60 people14 days
honey combined with chitosan nanosheets improved wound healing markers compared to control, and honey increased the effect of the nanoparticles
Who was studied
adult male mice with surgical skin wounds
What they received
honey combined with chitosan nanosheets (type of honey not specified as manuka)
Compared with
untreated control, polyethylene glycol, or chitosan nanosheets alone
Main outcome
wound healing measured by inflammation, fibroblast growth, new skin growth, and collagen formation
Quality
this is a small animal study in mice, not humans, using an unspecified type of honey combined with another treatment, so it cannot tell us whether manuka honey alone helps human wounds heal.
Limitations
animal model only, honey not identified as manuka, honey was combined with chitosan nanoparticles rather than tested alone, small group sizes
Taken word for word from the abstract
- population The skin excisional wound injury model was made in adult male BALB/c mice (n = 60) by creating two identical sized wounds (5mm) on either side of their dorsal midline.
- intervention CNSs dissolved either in honey or polyethylene glycol
- comparator The animals were divided into five groups (n = 12 each) as untreated control, honey, polyethylene glycol, and CNSs dissolved either in honey or polyethylene glycol.
- primaryOutcome The histological parameters including inflammatory cells infiltration, fibroblast proliferation, re-epithelialization, granulation formation, and collagen formation were evaluated in all studied time points.
- result Compared to the control group, CNSs showed significant wound healing activities with lower inflammatory cells infiltration, higher fibroblastosis and new epithelium thickness, and greater granulation area and collagen fibers density in the ulcer bed. In addition, honey synergistically increased the wound healing activity of the studied nanoparticles.
- n The skin excisional wound injury model was made in adult male BALB/c mice (n = 60) by creating two identical sized wounds (5mm) on either side of their dorsal midline.
Int J Low Extrem Wounds · PMID 35188413 · Read it on PubMed ↗
Joshi et al. 2021
Exploring the frostbite healing potential of hyaluronic acid based hydrogel of Manuka honey through in-silico antithrombotic and anti-platelet studies of major phytoconstituents and in-vivo evaluation in Wistar rat model
Healed frostbite wounds in rats (combo gel)Animal studyVery low qualityRelated question
size not given18 days
The hydrogel formulation showed complete wound healing within 18 days and good frostbite healing activity
Who was studied
Wistar rats with frostbite-induced wounds
What they received
A hydrogel combining hyaluronic acid and Manuka honey applied to the wound
Main outcome
Wound healing and closure after frostbite injury
Quality
This is a small animal study using frostbite wounds in rats treated with a combination product, not isolated manuka honey, and not surgical or human wounds, so it says little about manuka honey for anorectal surgery wounds in people.
Limitations
Animal model only (rats), frostbite wounds rather than surgical wounds, and the product tested combines hyaluronic acid with Manuka honey rather than honey alone; no comparator group or human data reported.
Taken word for word from the abstract
- population in-vivo frostbite healing evaluation was carried out in Wistar rats, by inducing frostbite with a supercooled rod
- intervention Development of Frostbite healing hydrogel of Manuka honey and hyaluronic acid
- primaryOutcome The wound contraction studies and histopathological evaluation reveals that the hydrogel also has a good frostbite healing activity
- result showing complete wound healing within an 18-day period
Drug Dev Ind Pharm · PMID 34633264 · Read it on PubMed ↗
Scepankova et al. 2021
Role of Honey in Advanced Wound Care
General review, no patient results.Narrative reviewVery low qualityRelated question
size not given2021
Review describes honey's properties (antioxidant, antimicrobial, anti-inflammatory) and healing advantages such as faster skin repair and fewer infections, based on in vitro and in vivo studies, without reporting its own clinical trial results
Who was studied
not specified for a particular patient group
What they received
topical honey applied to wounds
Compared with
none specified
Main outcome
wound healing properties and mechanisms
Quality
This is a general narrative review summarizing lab and animal findings, not a clinical study testing manuka honey in surgical wound patients.
Limitations
No patient population studied directly, no anorectal surgery context, no manuka-specific data isolated, no quantitative trial results reported in the abstract.
Taken word for word from the abstract
- population wound-healing-based applications
- intervention the use of honey for wound-healing solutions
- comparator Honey is a natural product rich in several phenolic compounds, enzymes, and sugars with antioxidant, anticarcinogenic, anti-inflammatory, and antimicrobial potential.
- primaryOutcome This paper reviews the main role of honey on the development of wound-healing-based applications, the main compounds responsible for the healing capacity
- result the acceleration of dermal repair and epithelialization, angiogenesis promotion, immune response promotion and the reduction in healing-related infections with pathogenic microorganisms
Molecules · PMID 34443372 · Read it on PubMed ↗
Anastasiou et al. 2021
Therapeutic Properties of Honey for the Management of Wounds; Is There a Role in the Armamentarium of Diabetic Foot Ulcer Treatment? Results From In vitro and In vivo Studies
Helped healing in lab and animal studiesNarrative reviewVery low qualityRelated question
size not given2021
Honey was associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing in diabetic animal models and showed antioxidant, anti-inflammatory, and antibacterial effects in vitro
Who was studied
Diabetic animal models and lab-grown skin cells (keratinocytes and fibroblasts), not human surgical patients
What they received
Topical honey (several types, not specified as manuka) applied to wounds
Compared with
No specific comparator described; review of untreated or standard-care wounds in lab/animal studies
Main outcome
Wound healing properties, including re-epithelialization, collagen production, wound contraction, and healing speed
Quality
This is a narrative review of lab (in vitro) and animal studies, not human clinical trials, so it cannot show whether honey actually helps real patients' wounds heal.
Limitations
Findings come from in vitro cell studies and diabetic animal models, not human surgical or anorectal wound patients, and the honey type is not specified as manuka.
Taken word for word from the abstract
- population in vitro studies of keratinocytes and fibroblasts, as well as studies in diabetic animal models
- intervention the efficacy and/or mechanism of action of several types of honey used for the treatment of diabetic animal wounds
- primaryOutcome treatment with honey is associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing
- result Honey has antioxidant, anti-inflammatory, and antibacterial properties and in vitro studies of keratinocytes and fibroblasts, as well as studies in diabetic animal models show that treatment with honey is associated with increased re-epithelialization and collagen production, higher wound contraction, and faster wound healing
- comparator honey seems to be a safe and cost-effective therapeutic approach on top of standard of care
Int J Low Extrem Wounds · PMID 34142897 · Read it on PubMed ↗
Felbaum et al. 2021
Manuka Honey: Feasibility and Safety in Postoperative Neurosurgical Wound Care
Seemed safe; effect on healing unclearCase seriesVery low qualityRelated question
25 people2021
7 of 25 patients still needed surgical debridement and long-term antibiotics; no side effects from the honey were reported, and the authors felt it may have helped prevent debridement in most patients
Who was studied
Patients recovering from brain or spine surgery with wounds that were not healing well or were at risk of breaking open
What they received
Topical active Leptospermum manuka honey (ALH) gel or ointment applied once daily to the surgical wound for 2 to 4 weeks
Compared with
No comparison group; all patients received manuka honey
Main outcome
Whether the wound healed without needing surgical debridement, and whether any side effects occurred
Quality
This is a small, retrospective case series with no comparison group, so it cannot show whether the honey itself changed healing outcomes.
Limitations
Small sample size, single surgeon, retrospective design, no control group, and the wound population was neurosurgical (cranial and spinal) rather than anorectal surgery.
Taken word for word from the abstract
- population patients with nonhealing wounds or wounds deemed "at risk" as defined by grade 1 Sandy surgical wound dehiscence grading classification
- intervention An ALH gel or ointment was applied to these incisions once a day for 2 to 4 weeks.
- comparator All 25 patients were prescribed a topical application of ALH
- primaryOutcome Twenty-five postoperative patients (12 cranial, 13 spinal) were identified to be at high risk of operative debridement.
- result Seven (four cranial, three spinal) patients required operative debridement and treatment with long-term antibiotic therapy.
- result The ALH may have prevented the need for operative debridement in the majority of patients.
- n Twenty-five postoperative patients (12 cranial, 13 spinal) were identified
Adv Skin Wound Care · PMID 33852461 · Read it on PubMed ↗
De Clercq et al. 2021
Effects of various wound dressings on microbial growth in perfused equine musculocutaneous flaps
No clear benefit over other dressingsLaboratory studyVery low qualityRelated question
16 people24 hours
Manuka honey dressings did not significantly reduce bacterial growth compared to most other dressings, and bacteria still increased from baseline in Pseudomonas-infected wounds despite the honey dressing; only cadexomer iodine consistently reduced bacterial growth
Who was studied
Skin wounds created on cadaver (dead) horse tissue samples, infected with bacteria
What they received
Wound dressing containing manuka honey
Compared with
Other dressings (cadexomer iodine, silver, boric acid, biguanide, alginate, charcoal) and plain gauze
Main outcome
Amount of bacteria growing in the wound tissue over 24 hours
Quality
This was a lab experiment on dead horse tissue, not real healing wounds in living patients, so it tells us little about whether manuka honey helps people heal.
Limitations
Nonviable (dead) tissue model using horse cadavers, not living patients or human surgical wounds; results may not reflect real wound healing
Taken word for word from the abstract
- population Abdominal musculocutaneous flaps from 16 equine cadavers.
- intervention covered with a dressing containing activated charcoal, boric acid, cadexomer iodine, calcium alginate, manuka honey, nanoparticle silver, or polyhexamethylene biguanide or with a control (nonadherent gauze) dressing
- comparator or with a control (nonadherent gauze) dressing
- primaryOutcome Muscle biopsy specimens were obtained at baseline (immediately prior to dressing application) and 6, 12, 18, and 24 hours later for mean bacterial load (MBL) determination.
- result For P aeruginosa-inoculated wounds, MBLs were significantly increased from baseline in all wounds at various times except for wounds with cadexomer iodine dressings.
- result The MBLs of wounds with cadexomer iodine dressings were lower than all others, although not always significantly different from those for wounds with boric acid, manuka honey, nanoparticle silver, and polyhexamethylene biguanide dressings.
- n Abdominal musculocutaneous flaps from 16 equine cadavers.
Am J Vet Res · PMID 33629894 · Read it on PubMed ↗
Mosteiro-Miguéns et al. 2021
Successful Treatment of a Venous Leg Ulcer With Manuka Honey: A Case Study
Chronic leg ulcer healed with manuka honey.Case seriesVery low qualityRelated question
1 people38 days
The main ulcer fully healed within 38 days of starting manuka honey, and a nearby ulcer also improved; pain improved by day 17
Who was studied
A man with a long-lasting venous leg ulcer that had not healed with other treatments
What they received
Topical manuka honey applied to the wound
Compared with
His own wound's lack of progress on previous treatments (iodine ointment, fiber dressings, hydrocolloid, compression, antibiotics)
Main outcome
Whether the wound healed (epithelialized)
Quality
This is a single patient case report with no control group, so the improvement could be due to other factors and cannot be generalized.
Limitations
Single patient, no comparison group, venous leg ulcer rather than a surgical or anorectal wound
Taken word for word from the abstract
- population a patient with a VLU refractory to multiple treatment strategies
- intervention we then initiated treatment with Manuka honey
- 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
- result His primary VLU was completely epithelialized within 38 days, and an adjacent VLU also showed progression toward healing.
- n Mr S. was a 76-year-old man with multiple comorbid conditions
J Wound Ostomy Continence Nurs · PMID 33427815 · 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 and transfusionCase seriesVery low qualityRelated question
1 people4 months
the ulcer progressively improved and fully closed after 4 months of treatment
Who was studied
young adult with sickle cell anemia and a long-standing leg ulcer
What they received
local honey dressing on the wound plus blood transfusion
Main outcome
wound healing and closure of the ulcer
Quality
this is a single patient case report without a control group, and honey was combined with blood transfusion so the effect of honey alone cannot be separated out.
Limitations
single case, no control group, honey combined with another treatment (transfusion), honey type not specified as manuka, and the wound was a sickle cell leg ulcer rather than a surgical or anorectal wound
Taken word for word from the abstract
- n EA was a 20-year-old university undergraduate
- population We report a case of chronic leg ulcer, in a known sickle cell anemia patient
- intervention The wound was dressed with local honey, and anemia corrected with blood transfusion using concentrated red cells lacking the HbS trait.
- primaryOutcome There was a progressive improvement in the healing of the ulcer with total closure after 4 months of treatment.
- result There was a progressive improvement in the healing of the ulcer with total closure after 4 months of treatment.
Ann Afr Med · PMID 33243953 · Read it on PubMed ↗
Shamloo et al. 2021
Fabrication and evaluation of chitosan/gelatin/PVA hydrogel incorporating honey for wound healing applications: An in vitro, in vivo study
Faster healing in rats with hydrogel honeyAnimal studyVery low qualityRelated question
size not given2021
Adding honey to the hydrogel increased antibacterial activity, improved cell survival up to an optimal amount, and sped up wound healing with better skin structure in rats
Who was studied
Rats with wounds in a lab experiment, not human surgical patients
What they received
A chitosan/gelatin/PVA hydrogel material with honey mixed in, not plain topical manuka honey
Compared with
Hydrogels with different honey concentrations compared to each other (comparator not clearly isolated as honey vs no honey)
Main outcome
Speed and quality of wound healing, including skin structure and collagen on histology
Quality
This was an animal and lab experiment with an unspecified type of honey mixed into a composite material, not a human study of manuka honey alone.
Limitations
Animal model only, honey type not identified as manuka, honey was combined with a synthetic hydrogel rather than tested as a standalone topical treatment, and no mention of anorectal surgery or human patients.
Taken word for word from the abstract
- population In vivo studies, including wound healing mechanism using rat model and histological analysis of section tissue samples were performed.
- intervention physically cross-linked hydrogels were developed by freezing-thawing method while different concentrations of honey were included into the hydrogels for accelerated wound healing
- comparator the effect of honey concentrations on antibacterial properties, and cell behavior was investigated
- primaryOutcome wound healing mechanism using rat model and histological analysis of section tissue samples were performed
- result the integration of honey into the hydrogel matrix results in the maintenance of a well-structured layer of epidermis containing mature collagen and accelerates the rate of wound healing
Int J Pharm · PMID 33188894 · 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 healing with honey dressingRandomised trialModerate qualityRelated question
99 people2021
Honey group healed faster (median 7 days vs 9 days) and were about 1.9 times more likely to be fully healed at any given time
Who was studied
Critically ill children in intensive care with pressure injuries (not anorectal surgery patients)
What they received
Medicated manuka or active Leptospermum honey dressing on pressure wounds
Compared with
Standard routine wound care
Main outcome
Time to complete wound healing
Quality
It was a multicenter randomized trial with a clear benefit shown, but it was open-label (no blinding) and studied a different population and wound type than anorectal surgery.
Limitations
Open-label design (no blinding) and the population was critically ill children with pressure injuries, not surgical anorectal wounds in adults.
Taken word for word from the abstract
- 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 for the management of their pressure injury.
- 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).
- n A total of 99 children were enrolled: 51 in the intervention group and 48 in the standard care group.
Pediatr Crit Care Med · PMID 33181730 · Read it on PubMed ↗
Rodriguez et al. 2023
Preliminary Clinical Evaluation Using a Novel Bioengineered Wound Product to Treat Lower Extremity Ulcers
Wounds closed quickly with combination product.Case seriesVery low qualityRelated question
12 people8 weeks
9 of 12 patients reached 100% wound closure within 8 weeks, with an average closure time of 4.1 weeks; at 4 weeks the average wound closure was 94%
Who was studied
Patients with lower extremity ulcers, including diabetic foot ulcers, that had not healed well with standard care or other treatments
What they received
A bioengineered wound product made of gelatin, Manuka honey, and hydroxyapatite applied to wounds (not manuka honey alone)
Compared with
None - no control group, single-arm evaluation
Main outcome
Time to full wound closure
Quality
This was a tiny study of only 12 patients with no comparison group, so it cannot show whether the product (or the honey in it) actually caused the healing seen.
Limitations
Very small sample size (12 patients), no control or comparator group, preliminary evaluation across only 4 sites, and the product tested combines manuka honey with gelatin and hydroxyapatite rather than testing manuka honey alone.
Taken word for word from the abstract
- population evaluate lower extremity ulcers treated with a novel bioengineered wound product (BWP)
- population The patients in this evaluation spanned across 4 sites and had complicated medical histories, including little to no progression of healing with standard of care or treatment with other biomaterials.
- intervention The BWP, a solid absorbable and conformable sheet composed of gelatin, Manuka honey, and hydroxyapatite, was applied on 12 patients with lower extremity ulcers.
- comparator The BWP, a solid absorbable and conformable sheet composed of gelatin, Manuka honey, and hydroxyapatite, was applied on 12 patients with lower extremity ulcers.
- primaryOutcome Nine patients had the BWP applied to aid in full closure.
- result These patients achieved 100% closure within 8 weeks, with a mean closure time of 4.1 weeks.
- result At 4 weeks, the mean percent wound closure was 94%.
- n was applied on 12 patients with lower extremity ulcers
Int J Low Extrem Wounds · PMID 33121306 · Read it on PubMed ↗
Al-Musawi et al. 2020
Antibacterial Activity of Honey/Chitosan Nanofibers Loaded with Capsaicin and Gold Nanoparticles for Wound Dressing
Faster healing in rabbits, not honey aloneAnimal studyVery low qualityRelated question
size not given2020
The combined honey/chitosan/capsaicin/gold nanoparticle nanofibers inhibited bacteria, increased cell proliferation, and improved wound-closure rate compared with untreated controls
Who was studied
Rabbits with wounds (New Zealand white rabbits), plus in vitro bacterial and cell testing
What they received
Honey/chitosan nanofiber dressings combined with capsaicin and gold nanoparticles (not manuka honey alone)
Compared with
Untreated control samples, and antibiotics in bacterial testing
Main outcome
Antibacterial activity, cell proliferation, and wound-closure rate
Quality
This is early-stage lab and animal testing of a complex multi-ingredient nanofiber material, not plain manuka honey, so it cannot show whether honey itself helps real patients heal.
Limitations
Animal (rabbit) and in vitro study only, not human patients; tested a combination nanofiber product with capsaicin and gold nanoparticles rather than manuka honey alone; no mention of anorectal surgery or surgical wound patients; sample sizes not reported.
Taken word for word from the abstract
- population in vivo study of the wound-closure process was performed on New Zealand white rabbits
- intervention honey/tripolyphosphate (TPP)/chitosan (HTCs) nanofibers loaded with capsaicin derived from the natural extract of hot pepper (Capsicum annuumL.) and loaded with gold nanoparticles (AuNPs)
- comparator In vitro antibacterial testing against Pasteurella multocida, Klebsiella rhinoscleromatis,Staphylococcus pyogenes, and Vibrio vulnificus was conducted in comparison with difloxacin and chloramphenicol antibiotics.
- comparator The MTT assay demonstrates that the nanofibrous mats increased cell proliferation compared with the untreated control
- primaryOutcome In vitro antibacterial testing against Pasteurella multocida, Klebsiella rhinoscleromatis,Staphylococcus pyogenes, and Vibrio vulnificus was conducted
- primaryOutcome Cell viability and proliferation of the developed nanofibers were evaluated using an MTT assay
- result In vivo results show that the developed mats enhanced the wound-closure rate more effectively than the control samples.
Molecules · PMID 33080798 · Read it on PubMed ↗
Foster et al. 2020
Honey dressings for diabetic foot ulcers: overview of evidence-based practice for novice researchers
No wound-healing result reported here.Narrative reviewVery low qualityRelated question
size not given2020
The abstract does not report a clinical result; it describes a methodology exercise for appraising one selected study on honey dressings
Who was studied
People with diabetic foot ulcers
What they received
Honey dressings (type not specified as manuka)
Main outcome
Not reported — this article is about how to critically appraise evidence, not a clinical outcome
Quality
This is a teaching exercise about how to do evidence appraisal, not a study reporting wound-healing outcomes, and it concerns diabetic foot ulcers rather than anorectal surgery wounds.
Limitations
The abstract gives no details of wound healing results, sample size, or whether manuka honey specifically was used; the population (diabetic foot ulcers) differs from the anorectal surgery question.
Taken word for word from the abstract
- population honey dressings for diabetic foot ulcers
- intervention honey dressings for diabetic foot ulcers
- primaryOutcome A literature review of published evidence on honey dressings for diabetic foot ulcers was conducted
- result The strengths and limitations of a selected study were appraised, and its implications for practice considered.
Br J Community Nurs · PMID 32886549 · Read it on PubMed ↗
Karavasili et al. 2020
Physico-mechanical and finite element analysis evaluation of 3D printable alginate-methylcellulose inks for wound healing applications
Lab material test only, not patients.Laboratory studyVery low qualityRelated question
size not given2020
The hydrogels showed good swelling, antimicrobial/antibiofilm activity, good biocompatibility, and stimulated cell growth in a lab-based wound healing assay
Who was studied
Human dermal fibroblast cells in vitro (not patients)
What they received
3D-printed alginate-methylcellulose hydrogel containing Manuka honey, aloe vera gel, and eucalyptus essential oil
Compared with
Different hydrogel compositions compared to each other (no human wound comparator)
Main outcome
Mechanical properties, antimicrobial effect, and cell growth in lab tests
Quality
This is a laboratory material-science study on cells and hydrogel films, not a clinical study on patients with wounds.
Limitations
In vitro lab study only, no human patients, no surgical wounds, no anorectal surgery context, and manuka honey is only one of three bioactive components tested together.
Taken word for word from the abstract
- population All hydrogel compositions showed good biocompatibility on human dermal fibroblasts, stimulating cell growth as confirmed by an in vitro wound healing assay.
- intervention 3D printable alginate-methylcellulose hydrogels with bioactive components (Manuka honey, aloe vera gel, eucalyptus essential oil)
- comparator The effect of the bioactive compounds on the viscosity and mechanical properties of the 3D printable hydrogels was assessed with rheological, nanoindentation and shear test measurements.
- primaryOutcome comprehensive physico-mechanical evaluation of 3D printable alginate-methylcellulose hydrogels
- result The 3D printable carbohydrate inks demonstrated good swelling properties under moist conditions and adequate antimicrobial and antibiofilm efficacy against both Gram positive and negative bacteria.
Carbohydr Polym · PMID 32829794 · Read it on PubMed ↗
Mukhopadhyay et al. 2020
Dual cross-linked honey coupled 3D antimicrobial alginate hydrogels for cutaneous wound healing
Honey-gel healed wounds in mice.Animal studyLow qualityRelated question
size not given12 days (in vitro degradation monitoring)
The honey-alginate hydrogel (especially at 4% honey) produced near-complete wound closure (94.56% contraction) with skin structure resembling normal unwounded skin, and also showed antimicrobial activity against MRSA and E. coli
Who was studied
Mice with skin wounds (murine wound model)
What they received
Honey mixed into an alginate hydrogel dressing (not plain manuka honey)
Compared with
Different honey concentrations within the same hydrogel formulation
Main outcome
How well the wound closed/healed and tissue structure of the healed skin
Quality
This is a lab and animal (mouse) study of a combination honey-alginate hydrogel material, not a human trial of manuka honey, so it cannot show whether manuka honey itself helps wound healing in people.
Limitations
Animal (murine) model only, no human data; honey type not specified as manuka; tested as part of a combined alginate hydrogel material rather than honey alone; no mention of anorectal surgery or surgical wound patients.
Taken word for word from the abstract
- population The in vivo wound contraction kinetics on murine models
- intervention Dual crosslinked (ionically and covalently) sodium alginate hydrogel coupled with honey (HSAG)
- comparator honey concentrations in HSAGs are varied from 2% to 10%
- primaryOutcome The in vivo wound contraction kinetics on murine models (4% HSAG treated wound contraction: 94.56 ± 0.1%) has been monitored by both invasive (histopathology) and noninvasive (Swept Source Optical Coherence Tomography) imaging
- result 4% HSAG treated wound closure achieved epithelial thickness resembling to that of unwounded skin
Mater Sci Eng C Mater Biol Appl · PMID 32806236 · 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 test only, no patient data.Laboratory studyVery low qualityRelated question
size not given2020
vacuum-prepared honey killed more MRSA bacteria and showed faster wound closure in lab tests than cooked honey
Who was studied
not applicable (in vitro experiments, no patients)
What they received
manuka honey microneedles made with different preparation methods
Compared with
different honey preparation methods compared to each other (cooked vs vacuum-treated)
Main outcome
bacteria killed (MRSA) and wound closure in lab assays
Quality
This was a lab-only experiment with no patients, so it cannot show whether manuka honey helps real wounds heal.
Limitations
In vitro study only; no animal or human wound data; no patients studied.
Taken word for word from the abstract
- population MHMs were synthesized using multiple methods and evaluated with in vitro assays.
- intervention Manuka honey (MH) is currently used as a wound treatment
- comparator while the cooked honey had incomplete wound closure, the vacuum-treated honey trended towards faster wound closure
- primaryOutcome MHMs demonstrated excellent bactericidal activity against MRSA at concentrations ≥ 10% of honey
- result 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.
Sci Rep · PMID 32764604 · Read it on PubMed ↗
Smaropoulos et al. 2021
Medical-Grade Honey for the Treatment of Extravasation-Induced Injuries in Preterm Neonates: A Case Series
All wounds healed with honeyCase seriesVery low qualityRelated question
7 people7 to 67 days (median 32 days) until wound closure
all wounds healed with new tissue growth and closed within 7 to 67 days, with no infection seen
Who was studied
preterm newborn babies with IV fluid leakage (extravasation) injuries
What they received
daily cleaning and application of medical-grade honey to the injured skin
Compared with
none - no comparison group
Main outcome
wound healing and closure
Quality
this is a tiny case series of only 7 babies with no comparison group, so it cannot show whether honey worked better than doing nothing.
Limitations
no control group, very small number of patients, and the babies and wound type (IV leakage injury in preterm infants) are different from anorectal surgical wounds; honey type is called medical-grade, not specifically identified as manuka.
Taken word for word from the abstract
- n We present a case series of 7 preterm neonates
- population 7 preterm neonates (28-36 weeks of gestation) with extravasation injuries secondary to peripheral intravenous administration of total parental nutrition and medication
- intervention All extravasation injuries were treated with daily cleaning and application of MGH
- comparator All extravasation injuries were treated with daily cleaning and application of MGH.
- primaryOutcome wound healing
- result all extravasation injury wounds presented with granulation tissue formation progressed to normal epithelialization and closed in 7 to 67 days (median: 32 days)
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 findings on honey reportedNarrative reviewVery low qualityRelated question
size not given2020
The abstract does not report any specific findings, data, or conclusions about manuka honey; it is mentioned only as a search term used to find literature, and no results for it are given in the Results or Conclusion sections.
Who was studied
children with non-healing wounds from various causes
What they received
Manuka honey was only listed as a search term used to find sources
Quality
This is a broad narrative review of pediatric wound care overall, and it does not actually report any findings, outcomes, or data specific to manuka honey.
Limitations
The review covers pediatric wounds generally (not anorectal surgery), lacks a systematic synthesis method, and provides no actual results, outcome data, or quality assessment for manuka honey specifically.
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, with some causes being iatrogenic, including extravasation injuries and medical device-related hospital-acquired pressure ulcers.
- intervention 'Apligraf', 'dermagraft', 'Manuka honey', 'antibiotic', 'timolol', and 'negative pressure wound therapy' (NPWT).
- result RESULTS: 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.
J Wound Care · PMID 32530778 · Read it on PubMed ↗
Yilmaz et al. 2020
HONEY DRESSING IN WOUND TREATMENT: A SYSTEMATIC REVIEW
Honey helped wounds heal faster.Systematic reviewLow qualityRelated question
size not given2020
honey was linked to faster skin regrowth, wound closure, anti-inflammatory and cleaning effects, less pain, better infection control, shorter healing time, and lower cost
Who was studied
people with acute and chronic wounds
What they received
honey used for wound treatment and care
Main outcome
wound healing outcomes including healing time, infection, and pain
Quality
this is a review of randomized trials but it looks at honey in general rather than manuka honey specifically, does not report how many patients were studied in total, and gives no detail on how good the included trials were.
Limitations
The abstract does not specify manuka honey as the type used, does not focus on anorectal surgery wounds, does not report a comparator group, and does not give the total number of patients across the 30 studies.
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 is based on thousands of years of history.
- primaryOutcome it was reported that honey in acute and chronic wounds 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
- result it was reported that honey in acute and chronic wounds 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 ↗
Naeimi et al. 2020
In vivo evaluation of the wound healing properties of bio-nanofiber chitosan/ polyvinyl alcohol incorporating honey and Nepeta dschuparensis
Faster healing in rats with honey-plant nanofiber.Animal studyVery low qualityRelated question
size not given21 days
Wound healing was faster within three weeks when honey and the plant extract were incorporated into the nanofiber mats
Who was studied
Rats with wounds
What they received
Honey combined with a chitosan/polyvinyl alcohol nanofiber mat and Nepeta dschuparensis plant extract
Main outcome
Speed of wound healing
Quality
This was a small animal (rat) experiment testing a combined honey-plant-nanofiber scaffold with no clear control group or sample size reported, so it says little about manuka honey alone in human wounds.
Limitations
Animal study only, honey type not specified as manuka, honey was combined with plant extract and synthetic nanofiber material rather than tested alone, no participant numbers or comparator group clearly given.
Taken word for word from the abstract
- population The in vivo wound healing studies on the rats for 21 days
- intervention electrospun polyvinyl alcohol and chitosan (PVA/Chit) nanofiber mats loaded honey and Nepeta dschuparensis plant for faster wound healing applications
- primaryOutcome PVA/Chit@Nep/Hon was investigated for wound healing therapy as a potential therapeutic agent
- result revealed the wound healing faster within three weeks by the incorporation of honey and plant into the nanofiber mats
Carbohydr Polym · PMID 32475579 · Read it on PubMed ↗
Sams-Dodd et al. 2020
Micropore Particle Technology Promotes Wound Healing, Whereas Polyhexamethylene Biguanide Causes Tissue Degeneration: A Case Report
Honey didn't help; wound worsened.Case seriesVery low qualityRelated question
1 people5 weeks
Counted as a related question: This case report tests whether manuka honey helps wounds heal by showing it failed and the wound deteriorated further over 5 weeks, then switches to other treatments; it does not compare manuka honey to a control or standard treatment to measure its effectiveness, making it a case of treatment failure rather than an evaluation of whether the treatment works.
After 5 weeks of manuka honey treatment, the wound deteriorated further
Who was studied
A woman with a spinal cord injury who had a large surgical wound from an abscess, extending down to the hip bone
What they received
Topical manuka honey applied to the wound
Compared with
After honey failed, treatment was switched to micropore particle technology and then to polyhexamethylene biguanide
Main outcome
Whether the wound healed or deteriorated
Quality
This is a single patient case report with no control group, so the result could easily be due to the wound's own course rather than the honey.
Limitations
Only one patient, no comparison group, and the wound had severe underlying problems (osteomyelitis, exposed bone) that could affect healing regardless of treatment.
Taken word for word from the abstract
- 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 Next, micropore particle technology (MPPT) was used.
- primaryOutcome The wound was initially treated for 5 weeks with Manuka honey but deteriorated further.
- result The wound was initially treated for 5 weeks with Manuka honey but deteriorated further.
- n A 72-year-old woman with a nontraumatic spinal cord injury developed eschar on her lower right back.
Wounds · PMID 32335523 · Read it on PubMed ↗
Smaropoulos et al. 2020
Medical grade honey for the treatment of paediatric abdominal wounds: a case series
Wounds healed well with honey.Case seriesVery low qualityRelated question
5 people2020
all wounds rapidly formed granulation tissue, re-epithelialised, had no infection, and minimal scarring with full range of motion preserved
Who was studied
young infants with abdominal wounds of different causes
What they received
daily application of medical grade honey to the wound
Compared with
none - no comparison group, all patients treated the same way
Main outcome
wound healing (granulation tissue formation, re-epithelialisation, infection, scarring)
Quality
This is a tiny, uncontrolled case series of only 5 children with abdominal wounds (not anorectal surgery), so it cannot show whether honey works better than anything else.
Limitations
No comparator group, very small sample (n=5), pediatric abdominal wounds of mixed causes rather than anorectal surgical wounds, and honey type described only as 'medical grade honey' not confirmed as manuka.
Taken word for word from the abstract
- population five young infants with abdominal wounds
- intervention daily medical grade honey applied to the wound area
- comparator All wounds were treated in the same manner with daily medical grade honey applied to the wound area and closely monitored.
- primaryOutcome All treated wounds rapidly presented granulation tissue formation and underwent re-epithelialisation.
- result All treated wounds rapidly presented granulation tissue formation and underwent re-epithelialisation. Peripheral oedema and inflammation decreased upon initial application. Necrotic tissue was effectively debrided when present. Slough was removed and no signs of infection were detected, irrespective of initial wound presentations. Scar formation was minimal and the full range of motion was preserved in all cases.
- n evaluating five young infants with abdominal wounds
J Wound Care · PMID 32058849 · Read it on PubMed ↗
Snelgrove et al. 2019
A review of interventions to reduce pain in chronic wounds
May reduce chronic wound painNarrative reviewVery low qualityRelated question
size not given2019
a honey dressing was found to reduce wound pain
Who was studied
patients with chronic wounds
What they received
honey dressing (type unspecified, not confirmed as manuka)
Main outcome
reduction of pain in chronic wounds
Quality
this is a non-systematic literature review with no study numbers, no patient counts, and no details on the type of honey used or the surgical context asked about.
Limitations
abstract does not specify systematic search methods, does not confirm manuka honey specifically, does not study anorectal surgery patients, and reports no sample sizes or statistical detail.
Taken word for word from the abstract
- population chronic wound pain
- intervention a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain
- primaryOutcome Reduction of chronic wound pain
- result a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain
Br J Community Nurs · PMID 31804887 · Read it on PubMed ↗
Biondo-Simões et al. 2019
Comparative analysis of the effects of honey, copaiba oil-resin and a commercial product (fibrinolysin, deoxyribonuclease and chloramphenicol) on second intention healing, in rats
Honey sped wound healing in ratsAnimal studyVery low qualityRelated question
40 people14 days
wound area reduction and type-I collagen were higher in the honey group than in the control group
Who was studied
rats with surgical skin wounds on their backs
What they received
topical honey applied to the wound
Compared with
wound cleaning alone (no honey) in a control group
Main outcome
wound area reduction, collagen formation and inflammation on healing
Quality
this is a small animal experiment using generic honey (not specified as manuka) on simple skin wounds in rats, not people or anorectal surgery, so it gives very weak evidence for the human question asked.
Limitations
animal (rat) model, small group sizes (10 per group), honey type not specified as manuka, wound type was a standardized skin excision rather than anorectal surgical wounds.
Taken word for word from the abstract
- population we carried out a skin resection, 1cm in diameter, on the back of 40 rats allocated to four groups of ten animals
- intervention we respectively applied 1ml of honey
- comparator The first group (control - GC) was restricted to such procedure
- primaryOutcome the wounds were copied and contraction was analyzed using planimetry. After euthanasia, we histologically evaluated the inflammatory reaction and collagen in the scars
- result the reduction of the wound area of GM (p=0.003), GO (p=0.011) and GF (p=0.002) were higher than the GC. The amount of type-I collagen present in GM and GO was higher than in GC and GF groups (p<0.05)
- n 40 rats allocated to four groups of ten animals
Rev Col Bras Cir · PMID 31778393 · 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 dental sockets, not anorectal woundsRandomised trialLow qualityRelated question
51 people7 days
wound sizes in the honey group were smaller than in the saline group on both day 3 and day 7
Who was studied
children aged 4 to 9 having a baby tooth pulled
What they received
honey placed on the gauze over the tooth socket
Compared with
normal saline solution placed over the tooth socket
Main outcome
size of the wound measured on days 3 and 7
Quality
this is a small trial in children's dental sockets, not manuka honey or anorectal surgical wounds, so it gives only weak and indirect evidence for the question asked.
Limitations
small sample size, honey type not specified as manuka, wound type is a tooth socket not anorectal surgery, and outcome was only wound size measurement rather than broader healing or complication rates.
Taken word for word from the abstract
- n 51 patients, 4‒9 years of age were selected randomly
- population tooth extraction wounds in children 4‒9 years of age
- 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 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)
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
Better healing in rabbit tooth socketsAnimal studyVery low qualityRelated question
6 people7 days
honey-treated sockets showed significantly more fibroblast proliferation and bony trabeculae formation than saline-treated sockets
Who was studied
rabbits having a tooth pulled
What they received
honey (type not specified as manuka) applied to the extraction wound
Compared with
normal saline applied to the opposite extraction wound
Main outcome
how well the tooth socket healed, measured by tissue biopsy
Quality
this was a tiny animal study (6 rabbits) looking at dental tooth-socket healing, not human anorectal wounds, and did not use or specify manuka honey.
Limitations
Very small number of animals, a non-human species, a dental extraction wound rather than anorectal surgery, and honey type not confirmed 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 biopsy was taken from the extraction site and histopathological examination was done
- 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)
- n six rabbits
Kathmandu Univ Med J (KUMJ) · PMID 33311037 · Read it on PubMed ↗
Smaropoulos et al. 2019
The pro-healing effects of medical grade honey supported by a pediatric case series
Honey seemed to help wounds heal.Case seriesVery low qualityRelated question
4 people2019
Medical grade honey kept wounds moist, showed antimicrobial activity, helped remove dead tissue and promoted healing; described as safe and easy to use
Who was studied
Children with wounds of different causes
What they received
Daily application of medical grade honey to the wound
Compared with
None (no comparison group, honey used alone)
Main outcome
Wound healing and prevention of infection
Quality
This is a tiny, uncontrolled case series of only four children with no comparison group, so it cannot reliably show whether honey caused the healing.
Limitations
Very small sample (n=4), no control group, pediatric population with mixed wound types, and the honey used is not specified as manuka honey; not related to anorectal surgery.
Taken word for word from the abstract
- population We here present a case series on the use of medical grade honey (MGH) in pediatric wounds.
- intervention All wounds were treated via monotherapy with daily MGH application.
- comparator All wounds were treated via monotherapy with daily MGH application.
- primaryOutcome We aim to illustrate the specific antimicrobial and pro-healing activity of MGH and support its easy and safe use.
- result Wound covering with MGH prevents pathogen infiltration and has antimicrobial activity. Moreover, MGH keeps the wound moist and possesses strong pro-healing effects, such as autolytic debridement of non-vital tissue and restoration of vascular structures.
- n Four pediatric patients with wounds of different origin are discussed in this prospective observational case series.
Complement Ther Med · PMID 31331551 · 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 the honey group healed completely vs 30% of controls, with significantly smaller wounds and less pain by day 90
Who was studied
elderly home care patients with non-healing wounds
What they received
honey dressings applied to the wound (type of honey not specified as manuka)
Compared with
conventional wound dressings
Main outcome
wound healing, wound size reduction, and pain intensity over 3 months
Quality
Small study of only 40 people in one country, and it did not specify the type of honey used, so it cannot confirm whether manuka honey itself works.
Limitations
Small sample size, single population (elderly home care clients, not surgical patients), and honey type not specified as manuka.
Taken word for word from the abstract
- population 40 Czech home care clients (aged over 65 years) with non-healing wounds who were randomly assigned to two groups
- intervention Wounds were treated with honey (intervention group)
- comparator or 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 There was a statistically significant difference in pain intensity between the two groups (p = 0.0007), with higher pain scores being indicated by controls
- n The sample comprised 40 Czech home care clients
J Tissue Viability · PMID 31000336 · Read it on PubMed ↗
Akbulut et al. 2019
Effect of a honey and arginine-glutamine-hydroxymethylbutyrate mixture on the healing of colon anastomosis in rats immunosuppressed with tacrolimus
Helped healing markers in rat gut surgeryAnimal studyLow qualityRelated question
size not given21 days
No significant difference in bursting pressure between groups; honey group showed more new blood vessel growth and increased TGF-β1, and gained weight more consistently
Who was studied
Rats given a drug to suppress their immune system, after colon surgery
What they received
Honey applied to the colon surgery site
Compared with
No honey (untreated or AGHMB mixture groups)
Main outcome
Strength and healing quality of the surgical bowel connection
Quality
This is a small animal study in rats, not humans, so it cannot reliably predict effects in people with anorectal wounds.
Limitations
Animal model, not human; uses general honey rather than specifically manuka honey; studies a different type of wound (internal colon anastomosis) rather than anorectal surgical wounds.
Taken word for word from the abstract
- population Sprague-Dawley rats were divided into four groups: untreated control, Tac, Tac + honey and Tac + AGHMB.
- intervention Tac + honey
- comparator untreated control, Tac
- primaryOutcome Anastomotic bursting pressure, macroscopic adhesion score, weekly body weight changes, histopathological features and immunohistochemical staining of TGF-β1 were determined for all groups.
- result We found no significant difference in anastomotic bursting pressure among the experimental groups.
- result Neovascularization in the Tac + honey group was significantly greater than for the Tac + AGHMB group.
- result We found that both honey and the AGHMB mixture were beneficial for anastomotic wound healing in rats that were immunosuppressed using Tac.
Biotech Histochem · PMID 30983411 · Read it on PubMed ↗
Hilliard et al. 2019
Preliminary investigation of honey-doped electrospun scaffolds to delay wound closure
Early lab/animal study, not human evidenceAnimal studyVery low qualityRelated question
size not given7 days (post-wounding day 7)
Honey scaffolds were not toxic to cells, allowed cell infiltration, promoted angiogenesis signals, and slowed/prevented rapid wound contraction in mice; collagen deposition was not affected at day 7
Who was studied
Mice with full thickness skin wounds (and lab cell cultures with macrophages/endothelial cells)
What they received
Manuka honey embedded in an electrospun PCL scaffold placed on wounds
Compared with
Scaffold without honey / untreated wound
Main outcome
Wound contraction, cell infiltration, collagen deposition, and angiogenesis markers
Quality
This is early-stage lab and mouse research on a honey-infused scaffold material, not a clinical study in human surgical wound patients, so it cannot show whether manuka honey helps people heal.
Limitations
Animal (mouse) and in vitro preliminary study only, no human wounds or anorectal surgery patients, no clinical healing outcomes measured, short follow-up (day 7 only reported)
Taken word for word from the abstract
- population In a full thickness murine wound model, the scaffolds prevented rapid wound contraction.
- intervention a poly (ε-caprolactone) (PCL) scaffold embedded with 1%, 5%, 10%, or 20% manuka honey
- comparator honey PCL scaffolds were not toxic to macrophages
- primaryOutcome In vivo, cells infiltrated the scaffolds by post-wounding day 7, but the honey scaffolds did not affect collagen deposition at that time.
- result preliminary studies investigating the effect of honey on tissue repair show that scaffolds prevent rapid wound contraction, allow for cell infiltration, and promote angiogenesis
J Biomed Mater Res B Appl Biomater · PMID 30866161 · 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 givenfirst one to two weeks
honey dressing shortened debridement time, healing time, and bacterial clearance time, and increased healing and bacterial clearance rates in the first one to two weeks
Who was studied
patients with diabetic foot ulcers
What they received
honey dressing applied to the wound
Compared with
other wound dressings
Main outcome
wound healing time, debridement time, and bacterial clearance
Quality
it pools randomized and non-randomized (quasi-experimental) studies without giving sample size or detail on bias, and the abstract itself says there is a lack of ample evidence.
Limitations
abstract does not specify honey type (not confirmed as manuka), studies were on diabetic foot ulcers rather than anorectal surgical wounds, and includes non-randomized studies; abstract states further research is needed.
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
- 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 honey dressing effectively shortened the wound debridement time, wound healing time, and bacterial clearance time; 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 using honey.Case seriesVery low qualityRelated question
12 people2019
All 12 patients healed using honey, avoiding surgery and hospital readmission
Who was studied
Patients with complex wounds who declined surgical debridement or skin grafting
What they received
Medical-grade active Leptospermum (manuka) honey applied to wounds
Compared with
No surgery (honey used instead of operative debridement or skin grafting)
Main outcome
Wound healing without surgery
Quality
This is a small, uncontrolled case series of only 12 patients with no comparison group, so it cannot reliably show the honey caused the healing.
Limitations
No control group, very small sample, no randomization, selection of patients who chose to avoid surgery, outcomes based on chart review and clinic follow-up rather than standardized measures.
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, utilize ALH as an alternative to surgery, and have regular follow-up visits
- intervention medical-grade honey (active Leptospermum honey [ALH])
- comparator as an alternative to surgery
- primaryOutcome The use of ALH 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 ↗
Kotian et al. 2018
The Role of Natural Medicines on Wound Healing: A Biomechanical, Histological, Biochemical and Molecular Study
Faster wound healing in rats, honey type unclearAnimal studyVery low qualityRelated question
size not given16 days
All treated groups showed faster skin regrowth, better tissue remodeling, more favorable inflammation, and good scar-forming cell activity compared to untreated wounds
Who was studied
Rats with surgical skin wounds
What they received
Honey (not specified as manuka), alone or combined with ghee, Glycyrrhiza glabra, and Nerium indicum
Compared with
Untreated control wounds
Main outcome
Wound healing measured by tissue strength, healing rate, inflammation markers, and scar remodeling
Quality
This is a small animal study that mixed honey with other remedies and never names manuka honey, so it cannot show what honey alone, let alone manuka honey, does for human surgical wounds.
Limitations
Animal (rat) model, number of animals not stated, honey was tested only in combination with other traditional remedies, and the honey type is not identified as manuka.
Taken word for word from the abstract
- population excision wounds in Wistar rats
- intervention Honey, Ghee, Glycyrrhiza glabra, and Nerium indicum
- comparator compared to control
- primaryOutcome biomechanical, histological and immunohistochemical (IHC) parameters were assessed at the wound site
- result Rapid epithelization, better remodeling, favorable inflammatory changes and an adequate myofibroblast activity at the wound site was observed in all the treated groups compared to control.
Ethiop J Health Sci · PMID 30607093 · Read it on PubMed ↗
Eroglu et al. 2018
The effect of different types of honey on healing infected wounds
Non-manuka honey helped infected wounds heal in ratsAnimal studyLow qualityRelated question
size not given14 days
Honey-treated wounds had higher hydroxyproline levels and better healing scores than controls, with no significant difference between 'mad honey' and nitrofurazone in tensile strength
Who was studied
Male Wistar rats with infected surgical wounds on their backs
What they received
Topical 'mad honey' or blossom honey applied to infected wounds
Compared with
Nitrofurazone ointment or no treatment (control)
Main outcome
Wound healing measured by hydroxyproline levels, tensile strength, and wound size/intensity
Quality
This was a small animal (rat) study using non-manuka honey types, so it doesn't directly test manuka honey in human surgical wounds.
Limitations
Animal model only, used 'mad honey' and blossom honey rather than manuka honey, and total sample size was not reported.
Taken word for word from the abstract
- population Male albino Wistar rats were randomly divided into four groups
- intervention 'mad honey' (MH), blossom honey (BH)
- comparator nitrofurazone (N) and control (C)
- primaryOutcome Tissue samples were assessed for hydroxyproline (HP), tensile strength (TS) and macroscopic measurement (area and intensity).
- result HP levels were higher in the treatment groups (MH, BH, N) at days 7 and 14 compared with the control group.
- result No marked difference was observed between the groups, nor any 'group x day' interaction, in terms of TS.
J Wound Care · PMID 30307813 · 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
No clear honey-specific healing resultAnimal studyVery low qualityRelated question
size not given14 days
The abstract reports strong antibacterial activity (>99%) for the dressings and shows that wound epithelialization/contraction improved in mice treated with the aloe vera-loaded dressing; it does not report in-vivo wound healing results specifically for the manuka honey-loaded dressing.
Who was studied
Mice with wounds, used to test experimental dressings
What they received
Dextran-based nanocomposite dressing containing manuka honey
Compared with
Dressing containing aloe vera instead of manuka honey (comparison unclear for manuka honey specifically)
Main outcome
Wound healing and antibacterial activity of the dressings
Quality
This is an early-stage animal/lab experiment testing a combination nanocomposite material, with no participant numbers given and wound-healing results reported mainly for the aloe vera component rather than manuka honey alone.
Limitations
Animal (mouse) study, not human patients or anorectal surgery; wound healing outcomes described are attributed to the aloe vera dressing, not clearly to the manuka honey dressing; no sample size 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 DNG/Ch/MH herbal dressings
- comparator DNG/Ch/AV and DNG/Ch/MH herbal dressings
- primaryOutcome Antibacterial studies confirmed >99% antibacterial activity against both Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) and bacterial adherence test demonstrated its efficacy for arresting microbial invasion.
- 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.
Int J Biol Macromol · PMID 30248422 · Read it on PubMed ↗
Negut et al. 2018
Treatment Strategies for Infected Wounds
General review, no specific resultNarrative reviewVery low qualityRelated question
size not given2018
the review states manuka honey shows encouraging antibacterial activity but gives no specific quantitative outcome data
Who was studied
people with infected or impaired skin wounds
What they received
manuka honey used in wound dressings
Quality
this is a general narrative overview of many wound treatments (essential oils, honey, nanoparticles) without a defined method, specific population, or reported outcome data for manuka honey alone, so it cannot show whether it works.
Limitations
The abstract does not describe a controlled comparison, patient population specifics, or measured outcomes for manuka honey; it is a broad review covering multiple antimicrobial wound strategies.
Taken word for word from the abstract
- population The treatment of skin wounds is a key research domain owing to the important functional and aesthetic role of this tissue.
- intervention with a special emphasis on Manuka honey
- result another natural product that exhibits encouraging antibacterial activity is honey
- result We highlight recent results of several studies carried out by researchers from different regions of the world on wound dressings impregnated with honey
Molecules · PMID 30231567 · Read it on PubMed ↗
Javadi et al. 2018
Synergistic effect of honey and Nigella sativa on wound healing in rats
Faster healing than no treatment, in ratsAnimal studyLow qualityRelated question
50 people20 days
Honey-treated wounds healed faster than control (lanolin) but not as fast as the honey plus Nigella sativa mix or phenytoin groups
Who was studied
Wistar rats with surgically created skin wounds on the back
What they received
topical honey applied to wound
Compared with
lanolin (control), Nigella sativa seed oil, honey plus Nigella sativa mix, phenytoin cream
Main outcome
wound surface area over time (days 5, 10, 15, 20)
Quality
This is a small animal study using generic honey (not specified as manuka) on rat skin wounds, not human anorectal surgical wounds, so it offers only weak and indirect support.
Limitations
Animal model (rats), honey type not specified as manuka, wounds were experimentally created skin excisions rather than human anorectal surgical wounds
Taken word for word from the abstract
- population A circular excision wound was established in the back region of 50 Wistar rats.
- intervention honey in the honey group
- comparator daily topical administration of lanolin in the control group, honey in the honey group, cold-pressed N. sativa seed oil in the N. sativa groups, mix of 1:1 ratio of honey and N. sativa seed oil in the mix group, and phenytoin cream in the phenytoin group were used
- primaryOutcome wound surface areas were evaluated using digital camera immediately after the injury and at post excision days 5, 10, 15 and 20
- result In the post excision days 5, 10, 15 and 20 the wound surface areas in the mix group were significantly lower than the other groups followed by the phenytoin, honey, N. sativa, and control groups.
- n 50 Wistar rats
Acta Cir Bras · PMID 30020313 · Read it on PubMed ↗
Costeloe et al. 2018
The use of honey in cochlear implant associated wounds in pediatric patients
Wounds healed with honey plus antibioticsCase seriesVery low qualityRelated question
3 people2018
all three patients achieved complete wound closure without needing surgery
Who was studied
children with skin ulcers around cochlear implants
What they received
medical grade honey gel (TheraHoney) added to wound care
Compared with
antibiotics alone (traditional treatment)
Main outcome
complete wound closure
Quality
only three cases with no control group and no comparison data, so it can't show whether honey itself caused the improvement
Limitations
Retrospective review of only three cases, no comparator group, honey used alongside antibiotics rather than alone, and the honey product is not specified as manuka honey.
Taken word for word from the abstract
- population cochlear implant associated skin breakdown
- intervention TheraHoney gel, a medical grade honey
- comparator Three cases of wounds treated traditionally with antibiotics, plus the addition of TheraHoney
- primaryOutcome complete wound closure
- result With the addition of TheraHoney gel, complete wound closure was achieved at all three patients without the need for surgical reconstruction.
- n Three cases of wounds treated traditionally with antibiotics, plus the addition of TheraHoney, were retrospectively reviewed.
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
Killed bacteria in lab dish onlyLaboratory studyVery low qualityRelated question
size not given2018
Manuka honey dressing showed high activity against all tested bacteria in the disc diffusion assay only, not in the time-killing assay
Who was studied
No patients; study used reference bacterial strains (Staphylococcus aureus, Staphylococcus epidermidis, Pseudomonas aeruginosa, Escherichia coli) in a laboratory setting, not wound patients
What they received
Manuka honey-containing wound dressing (Algivon) tested in vitro against bacteria
Compared with
Other commercially available dressings containing silver, chlorhexidine acetate, or povidone-iodine
Main outcome
Antimicrobial activity against four bacterial strains, measured by disc diffusion and time-killing assays
Quality
This is a laboratory dish test of bacteria killing, not a study of real wounds or patients, so it cannot show whether manuka honey actually helps wounds heal.
Limitations
In vitro laboratory testing only, no patients, no wounds, no clinical healing outcomes assessed; tests antimicrobial potency not wound healing
Taken word for word from the abstract
- population tested against four reference strains of bacteria: Staphylococcus aureus (PCM 2051), Staphylococcus epidermidis (PCM 2118), Pseudomonas aeruginosa (ATCC 27853), and Escherichia coli (K12)
- intervention High activity against all tested bacteria, but only in the disc diffusion assay, was observed for Algivon, which contains manuka honey.
- comparator eight selected, commercially available wound dressings containing different antimicrobial agents: silver, chlorhexidine acetate, povidone-iodine, and manuka honey
- primaryOutcome to 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 ↗
Sawazaki et al. 2018
Efficacy of Honeydew Honey and Blossom Honey on Full-thickness Wound Healing in Mice
Honey healed wounds worse than standard dressings in mice.Animal studyVery low qualityRelated question
140 people14 days
wounds treated with honey (including manuka) healed worse than standard dressings, with slower skin regrowth, more inflammatory cells, and poorer collagen formation after day 11
Who was studied
mice with surgical skin wounds
What they received
manuka honey applied topically to the wound, among other honey types tested
Compared with
hydrocolloid dressing or plain gauze dressing
Main outcome
how well the full-thickness wounds healed over 14 days
Quality
This is an animal study in mice, not humans, so it cannot reliably predict what happens in people with surgical wounds.
Limitations
Conducted in mice, not humans; tested several honey types together; not related to anorectal surgery or any human surgical setting.
Taken word for word from the abstract
- population A total of 140 mice were divided into 2 control groups
- intervention Manuka honey (n = 22)
- comparator hydrocolloid dressing (HCD; n = 22) or gauze (n = 22)
- primaryOutcome Two circular full-thickness wounds were made and measured for 14 days.
- result all of the honeys examined were less effective at promoting full-thickness wound healing than the controls
- n A total of 140 mice were divided into 2 control groups
Wounds · PMID 29718813 · Read it on PubMed ↗
Giusto et al. 2018
Pectin-honey hydrogel: Characterization, antimicrobial activity and biocompatibility
Lab material tested, not wound healing in patientsLaboratory studyLow qualityRelated question
size not given2018
The hydrogel showed good antibacterial activity, was not toxic to fibroblasts, and caused no harmful changes when implanted in rats
Who was studied
Cultured fibroblast cells and rats used for safety testing, not patients with wounds
What they received
A pectin-honey hydrogel wound dressing material (honey type not specified as manuka)
Main outcome
Material properties such as antibacterial activity and biocompatibility (not clinical wound healing)
Quality
This is a laboratory and animal material-testing study, not a clinical trial in patients with wounds, so it cannot show whether the honey hydrogel actually helps wounds heal in people.
Limitations
No human patients, no wound-healing outcome measured, honey not confirmed as manuka, no comparator group, and participant/animal numbers not reported.
Taken word for word from the abstract
- population Biocompatibility was assessed by proliferation assays using 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.
- primaryOutcome The properties of these pectin-honey hydrogels were investigated, 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 ↗
Boyar 2018
Treatment of Dehisced, Thoracic Neonatal Wounds With Single-Use Negative Pressure Wound Therapy Device and Medical-Grade Honey: A Retrospective Case Series
Case series, no isolated honey effect shownCase seriesVery low qualityRelated question
11 peopleUntil hospital discharge or transfer
All 11 neonates healed successfully with no complications related to the treatment; pain scores were acceptable and daily care was not disrupted
Who was studied
Newborn babies with infected, reopened chest wounds after heart surgery
What they received
Medical-grade manuka (Leptospermum) honey combined with a portable negative pressure wound therapy device
Compared with
No comparison group
Main outcome
Wound healing success and complications
Quality
This was a small, retrospective case series with no comparison group, so it cannot show whether honey itself helped versus the negative pressure device or usual care.
Limitations
Retrospective design, no control group, honey combined with another device so its separate effect cannot be judged, small number of patients, and a different population (newborns with heart surgery chest wounds) than anorectal surgery patients.
Taken word for word from the abstract
- population colonized or infected, dehisced, thoracic wounds in neonates with complex congenital heart disease
- intervention a portable, single-use negative pressure wound therapy device used in combination with activated active Leptospermum honey (ALH)
- comparator Retrospective, descriptive study.
- primaryOutcome Wound cultures were obtained on all patients prior to treatment commencement.
- result Use of ALH and a single-use negative pressure wound therapy device was successful in this series of 11 neonates with complex congenital heart disease.
- result No complications were observed related to the use of negative pressure wound therapy device and ALH.
- n We reviewed medical records of 18 neonates and reported on findings from 11
J Wound Ostomy Continence Nurs · PMID 29521921 · Read it on PubMed ↗
Hajizadeh et al. 2018
Effect of Topical Honey on Mandibular Bone Defect Healing in Rats
Faster bone healing in ratsAnimal studyVery low qualityRelated question
24 people2 and 4 weeks
Honey-treated defects showed more advanced healing stages and significantly more new bone formation than untreated defects at both 2 and 4 weeks
Who was studied
Wistar rats with surgically created bone defects in the jaw
What they received
Sterile honey placed in the bone defect
Compared with
No honey, defect left unfilled
Main outcome
Healing and new bone formation in the jaw defect
Quality
This is a small animal study of jawbone defects, not human soft-tissue or anorectal wounds, so it tells us little about whether manuka honey helps people heal after surgery.
Limitations
Animal (rat) study, small sample size, honey type not specified as manuka, and outcome is bone healing rather than soft-tissue surgical wound healing.
Taken word for word from the abstract
- population This animal study was performed on 24 wild-type Wistar rats.
- intervention the defect was filled with sterile honey
- comparator 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).
- n This animal study was performed on 24 wild-type Wistar rats.
J Contemp Dent Pract · PMID 29358534 · Read it on PubMed ↗
Lavaf et al. 2017
Comparison of honey and phenytoin (PHT) cream effects on intensity of pain and episiotomy wound healing in nulliparous women
Faster early healing, no less painRandomised trialLow qualityRelated question
120 people14 days
At 7 days, honey group had better (lower) healing scores than placebo; by 14 days no difference between groups; pain intensity was not different between groups at 7 or 14 days
Who was studied
women after childbirth with an episiotomy cut
What they received
honey cream applied to the wound
Compared with
placebo cream (and also compared with phenytoin cream)
Main outcome
wound healing score and pain intensity after delivery
Quality
small double-blind trial but in a different patient group (postpartum episiotomy, not anorectal surgery) and the honey type is not specified as manuka, so it only weakly informs this question.
Limitations
Population is postpartum episiotomy wounds, not anorectal surgery patients; honey is not specified as manuka honey; no long-term follow-up beyond 14 days.
Taken word for word from the abstract
- population 120 nulliparous women in three groups of phenytoin, honey and placebo
- intervention mothers used a knuckle of the prescribed creams on their episiotomy area
- comparator three groups of phenytoin, honey and placebo
- primaryOutcome Evaluation of wound healing using REEDA scale and pain intensity with numerical rating scale of pain
- result Healing score in the honey group was lower than that in placebo group. On the fourteenth day after delivery, the healing scores showed no significant differences between the three groups. Measuring pain intensity did not show any significant difference in the three groups after 7 and 14 days of delivery.
- n 120 nulliparous women in three groups
J Complement Integr Med · PMID 28981445 · Read it on PubMed ↗
Giusto et al. 2017
A new, easy-to-make pectin-honey hydrogel enhances wound healing in rats
Honey sped healing in rats, unclear if significant.Animal studyVery low qualityRelated question
36 people2017
Wound shrinkage was faster in the honey group than the control group, but the abstract reports a statistically significant speed-up only for the honey-pectin hydrogel, not for honey alone
Who was studied
Adult male rats with a surgically made skin wound
What they received
Liquid manuka honey applied directly to the wound
Compared with
Bandage only (no honey) in the control group
Main outcome
How fast the wound area shrank over time
Quality
This was a small animal (rat) experiment, not a human study, so it cannot tell us how manuka honey works for people's wounds.
Limitations
Animal model (rats, not humans), small number of animals per group, and no clear statement of statistical significance for the honey-alone group compared with control.
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
BMC Complement Altern Med · PMID 28511700 · Read it on PubMed ↗
Saikaly et al. 2017
Honey and Wound Healing: An Update
No specific result reported.Narrative reviewVery low qualityRelated question
size not given2017
The abstract summarizes mechanisms and says clinical studies comparing honey with traditional wound care are emerging, but does not state a specific result or direction of effect.
Who was studied
people with various skin wounds
What they received
honey applied to wounds (multiple types of honey)
Compared with
traditional wound care therapies
Main outcome
wound healing outcomes
Quality
This is a narrative review describing mechanisms and existing literature without reporting pooled or specific outcome data, so it cannot show whether honey works.
Limitations
No specific population, numbers, or quantitative results are reported; not focused specifically on manuka honey or anorectal surgery.
Taken word for word from the abstract
- population outcomes of clinical studies involving a multitude of cutaneous wounds are also examined
- intervention honey has been utilized for wound healing purposes
- comparator clinical studies comparing honey with traditional wound care therapies are steadily emerging
- primaryOutcome information regarding honey's mechanisms of action on wound healing has accumulated at a rapid pace
- result clinical studies comparing honey with traditional wound care therapies are steadily emerging
Am J Clin Dermatol · PMID 28063093 · Read it on PubMed ↗
Chamani et al. 2017
Evaluation of Honey as a Topical Therapy for Intraoral Wound Healing in Rats
Faster mouth-wound healing in rats.Animal studyVery low qualityRelated question
32 people8 days
wounds treated with honey were smaller, had less inflammation, and had more new tissue growth than untreated wounds
Who was studied
rats with small mouth wounds
What they received
honey applied to the wound
Compared with
no honey (control)
Main outcome
wound healing (ulcer size, inflammation, tissue regrowth)
Quality
this was a small animal experiment in rats' mouths, not humans, and did not specify manuka honey or anorectal surgery, so it says little about human surgical wound care.
Limitations
small animal study (rats), oral mucosal wounds rather than anorectal surgical wounds, honey type not specified as manuka
Taken word for word from the abstract
- population Thirty-two male rats were divided into experimental and control groups
- intervention Honey was applied to the wound every day
- comparator control groups
- primaryOutcome the size of ulcer, inflammatory response, reepithelialization, and granulation tissue formation
- result The mean rank of wound size was significantly reduced in the honey group (2.50), as compared to the control group (6.50).
- result Reepithelialization and granulation tissue formation mean rank were significantly higher in the honey group (6.50) than in the control group (2.50).
- n Thirty-two male rats were divided into experimental and control groups (consisting of 16 rats, 4 animals in each group).
Wounds · PMID 28054920 · 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 2026-10-14
The exact search — paste this into PubMed to repeat it: ("Honey"[Mesh] OR manuka[tiab]) AND ("Wound Healing"[Mesh] OR "Surgical Wound"[Mesh] OR "Postoperative Care"[Mesh] OR "Hemorrhoidectomy"[Mesh] OR "Rectal Fistula/surgery"[Mesh] OR "Pilonidal Sinus/surgery"[Mesh] OR "Anal Canal/surgery"[Mesh]); PubMed expanded that to: ("Honey"[MeSH Terms] OR "manuka"[Title/Abstract]) AND ("Wound Healing"[MeSH Terms] OR "Surgical Wound"[MeSH Terms] OR "Postoperative Care"[MeSH Terms] OR "Hemorrhoidectomy"[MeSH Terms] OR "rectal fistula/surgery"[MeSH Terms] OR "pilonidal sinus/surgery"[MeSH Terms] OR "anal canal/surgery"[MeSH Terms])
What came back: 464 records found · 200 read · 95 answered the question
Included: Human, animal or laboratory studies reporting an outcome relevant to the question
Excluded: Records about a different condition or intervention
Studies of Oral or dietary honey consumption for non-wound purposes — a different treatment from the one asked about
Studies of Honey used specifically for burns (separate wound type) — a different treatment from the one asked about
Studies of Other topical agents like silver dressings or antibiotic ointments studied without honey comparison — a different treatment from the one asked about
Studies of Non-manuka honey products used as a distinct, unrelated intervention — a different treatment from the one asked about
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.

464records came back from the search
200were read
95actually answered the question

Risks and safetyReported side effects and who should be careful.

A review of honey dressings for chronic wounds found they were linked to more pain during treatment in some studies, compared with other dressings.

Common questionsShort answers, drawn from the same studies.

Does manuka honey help heal wounds after hemorrhoidectomy, fistulotomy or pilonidal cyst surgery?: No study has tested this directly. The closest trial was in people with non-healing pilonidal wounds, and it used honey that wasn't confirmed to be manuka; it found no statistically significant difference in healing time between adding honey and not [36].
Is it safe to put manuka honey on a surgical wound?: Across the studies reviewed, no serious injury from applying honey to a wound was reported. One review of chronic wounds did note more pain during treatment with honey dressings in some studies [20], but safety specifically after anorectal surgery hasn't been tested.
Should I stop using manuka honey on my wound?: If your surgeon has given you a specific wound-care routine, follow that rather than substituting honey — there's no evidence manuka honey heals anorectal surgical wounds faster or better. Using it alongside standard care, if your surgeon agrees, hasn't been shown to cause harm in the studies reviewed.
Why do so many articles say manuka honey helps wounds heal?: Most of that evidence comes from laboratory dishes, mice, or unrelated wound types like diabetic foot ulcers — not anorectal surgery. Even in those other settings results are mixed, with some studies finding benefit and others finding no difference or slower healing [9,20,69].

What has changedEvery re-check, and whether it changed the answer.

2026-10-14
Re-reviewed under a revised method: question type, study relevance and the harm rule. 39 new studies · 86 no longer retrieved · conclusion signal of harm → not studied.
The conclusion changed.

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.

Contact the office

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.