Their is a product called Medihoney (Derma Sciences) that is used clinically.

Their is a product called Medihoney (Derma Sciences) that is used clinically.

Their is a product called Medihoney (Derma Sciences) that is used clinically.

Yes commercial preparations are available in some countries but even if u apply simple honey directly on the wounds ...you'll see wonderful results.

I do not know why you are saying it is not accepted : it is !

I know at least 3 of them being routinely coomercialised : MEDIHONEY - REVAMIL - MESITRAN .There is even one more that I do not remember the name/

In both health funds in Israel where I am working , honey treatment is in the basket of dressings in use and we are using them currently on a day to day basis.We have at least published 2 abstracts in EWMA ( european wound association) on the use of honey in burns and in diabetic wounds with sinuses ( included my profile)

With my best wishes of success in your work

Sorry, I did not pay attention to your remark on usual honey.

The problems are that any honey has its own characteristics of pH and specific antibacteriologic properties so that  you have know which are the ones of that you use.

One more remark is that the medical honey gets a treatment by gamma irradiation so that it kills germs that could be present in the honey and could be made it risky for use such as clostridium

Friendly yours

To my knowledge, there is no blinded RCT which demonstrate the effectiveness of Medihoney in diabetic foot ulcers. There is only one single center study which compares Medihoney against standard wound care. The results showed no differences (Standardized antibacterial honey (Medihoney) with standard therapy in wound care: randomized clinical trial. Robson V, Dodd S, Thomas S. J Adv Nurs. 2009 Mar;65(3):565-75. doi: 10.1111/j.1365-2648.2008.04923.x. PMID: 19222654). 

So why should we leave the effects of good standard wound care? Probably there are harmful effects of Medihoney which we do not know yet. In terms of working as a medical doctor the statement: "primum nihil nocere" should truly ever at first sight.

In my clinical practice I have been using honey in diabetic patients too . and I has shown good results. Patients responded well . yes the RCTs are required to prove it beyond doubt.

I think honey have many well proven qualities against infections in chronic wounds, the potential against biofilm infections (MRSA and PA) seems though to be "only" 70-90% (Alandejani et al., 2009). I think it is very important to choose a quality product, as a study has shown that many has bacterial contaminations (Carnwath et al., 2014). I am an equine clinician, and I also use medical honey on wounds with success (horses, like people, suffer from chronic wound healing)

We don't use Honey due to the lack of evidence other than in reduction of bacteria

Examine the Cochrane report on Honey

Cochrane review has not found much evidence of its effectiveness in diabetic foot ulcers but it was found effective in other type of ulcers like burn wounds and venous ulcers. Yes RCT#are required .

It is no because there is no RCT that it is not valuable.It just proves that  RCT should be performed given the valuable results of the good and experience folk that use it/

I may tell you that even not being a RCT our experience of additionnal value of honey against iodine solution alone in sinuses originating from diabetic foot ulcer with more than 80% closure and no side effects just should push us to build a good RCT,

If we are condamning new things becuse RCT was not (YET) performed there will never be any progress

Kindly yours

Thanks aharon....

I agree.... And this is why people are circumspect about its use. But it is a very good and cheap alternative. 

I  agree with the other responses.  Periodically, the use of honey resurfaces, but there have been no confirmatory studies that support its use.  If there have been well-designed trials, other than open use in a mixed bag of diseases, I am unaware of them.  This is reminiscent of Granulex® advocacy in the past - lots of hype and no substance.

By the way is there anything that can really be called a gold standard in wound healing:

I was taught that wound needs moisture to heal and my dear orthopedic surgeon friend and colleague in the team ( Dr Nahum Grinberg ) is drying all the diabetic foot ulcers with iodine and you know what ? he has the "hutzpah " to be successful ! So far that we think that a RCT should be performed on a large scale to better understand the problems of wound healing .

By the way I have to credit him with the idea of using revamil gel honey  in sinuses originating from diabetic foot ulcers.

I am deeply sorry that in our field of wound healing there is such a big lack of collaborative mulicenter well design trials.

Maybee this discussion could push the things forward.

Best regards to all ,agreeing with me or not

Yes its true.... We need more research on honey.. But try it yourself on your patients and then may be some one can initiate a trial. May be in near future I will conduct one myself but the good results will be seen only when we initiate it globally and share our data.....

agree with all - anecdotally, I have seen great results using manuka honey on diabetes related foot ulcers...but #RCT are lacking; The hole for evidence based, best practice medicine

Honey has some evidence for reducing bacteria in wound and may have a place, however there is little evidence of its ability to enhance healing. Honey is a concentrated sugar solution and will exert a strong osmotic effect on cells my concern is that this effects all cells not only bacterial cells.

Associate Professor Geoff Sussman 

Honey appears to heal partial thickness burns more quickly than conventional treatment (which included polyurethane film, paraffin gauze, soframycin-impregnated gauze, sterile linen and leaving the burns exposed) and infected post-operative wounds more quickly than antiseptics and gauze......

Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N.Honey as a topical treatment for acute and chronic wounds.Cochrane Database of Systematic Reviews 2015, Issue 3. Art. No.: CD005083. DOI: 10.1002/14651858.CD005083.pub4

Dear,  Please search for the aetiology of the ulcer first. then start treatment using dressing or not.   if you are sure that all factors of healing are ok (which when only one of them is missed, you will never have healing and you are approaching limb loss) so any dressing starting from; sterile saline, silver, Vac therapy, to split thickness graft will be ok according to size of ulcer.   but the case is usually either:

1- Missed diagnosis to one of the etiological factors leading to resistant healing and possible limb loss. also leads to thinking for abnormal dressings as with honey and ozone therapy, others with hyperbaric oxygen !!!

2- wrong management to the etiological factors detected

in my recent study on 1000 case  85% of resistant diabetic foot lesions have at least 3 etiological factors to be managed properlly in strategic way;

http://onlinelibrary.wiley.com/doi/10.1111/jdi.12425/abstract

Good Luck

http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150984