Santhosh Kumar S. S, Muhammed Sumarban Sharmad
BACKGROUND This was an open label study. Although, honey has been used for centuries in wound care, now only it is being integrated into modern medical practice. The resurgence of interest in honey as a medicine for modern wound dressing offers opportunities for both patients and clinicians. The aim of this study is to show the advantage of honey dressing over conventional saline dressing in the management of chronic non-healing ulcer. This property of honey is mentioned in papyruses traced to 3500 years ago among ancient Egyptians and the Hebrews 3000 years ago. Honey naturally contains small amounts of enzymes. The predominant enzymes in honey are diastase (amylase), invertase (alpha-glucosidase) and glucose oxidase. Honey has been proven to have significant antibacterial properties and is a useful constituent in wound and burn care. The stimulation of cell growth seen with honey is probably also responsible for ‘kick-starting’ the healing process in chronic wounds that have remained non-healing for long periods. Honey has a broad spectrum of activity against bacteria and fungi. Many randomised and non-randomised study has shown the efficacy of honey as a healing agent and excellent dressing material. MATERIALS AND METHODS Study was conducted in medical college, Trivandrum, which is a tertiary care centre. Patients are selected from orthopaedic and general surgical wards. The study period was one year extending from July 2014 to June 2015. Saline dressing was given for the patients admitted in the first 6 months of study. Honey dressing was given for the next 6 months of study. Outcome was assessed on duration of hospital stay, difference of outcome in different distribution of grades of ulcer, difference of outcome in patients with vascular compromise, which is found out by Doppler ultrasound and difference of outcome in patients with diabetes mellitus. RESULTS Most significant observations made were in regard to duration of hospital stay and better outcome in case of honey dressing compared to conventional saline dressing. Average duration of hospital stay in those dressed using normal saline was found to be 31.3 days. Mean duration in those dressed with honey was found to be 25.77 days. Difference in average duration of hospital stay in both groups was proven to be highly statistically significant with a p value of 0.000934. The number of patients that could be grafted during their hospital stay was significantly more in those dressed with honey. 63% of patients who were dressed with honey could be grafted during their hospital stay, whereas only 17% of normal saline dressing group could be grafted. This difference was proven to be statistically significant with a p value of 0.004. CONCLUSION The rate of amputations was also very much less in patients dressed with honey dressing. It was also noted that honey dressing turned more number of unsterile cultures sterile than normal saline. This difference was also proved statistically significant. Doppler findings were also noted in the beginning of study to see whether the efficacy of honey dressing is lesser in patients with vascular impairment. But, it was noted that there is no significant difference in the efficacy of honey dressing in both groups. The difference in number of diabetic patients included in honey and saline dressing was also proved not significant; thus confirming efficacy of honey dressing in diabetic and nondiabetic individuals.
