Intralesional application of medical grade honey improves healing of surgically treated lacerations in horses

Abstract

Summary Background Infection and dehiscence of simple lacerations is common in horses, and consistently effective methods of prevention are yet to be found. Honey has been shown to promote wound healing when applied topically; however, intralesional application prior to wound closure has not been reported. Objectives To examine whether intralesional application of medical grade honey (MGH) would reduce the incidence of infection and dehiscence following wound closure. Study design Prospective, open‐label randomised block design clinical study. Methods Lacerations, treated by field practitioners, were divided into treatment and control groups using block randomisation. Horses in the treatment group received a single intralesional treatment with l‐mesitran gel (MGH). Data were collected at the time of wound closure and at suture removal. Results Data from 127 horses were included, 69 MGH‐treated and 58 control cases. No adverse effects of the MGH were recorded. MGH‐treated horses were more likely to completely heal (P = 0.006, odds ratio [OR] 3.40 95% confidence interval [CI] 1.41–8.20), to have no signs of infection (P = 0.007, OR 3.64, CI 1.42–9.26) and for the veterinarians to report some degree of satisfaction (P = 0.04, OR 2.72, CI 1.05–7.09) compared to control cases. Numbers needed to treat for complete healing was 5.1 (CI 2.8–40). Main limitations Clinical studies have inherent flaws compared to wound healing models, because of variability between wounds. There were more horses with limb injuries in the control group, although not statistically significant, this may have biased the results. Clinical satisfaction and signs of infection were subjective evaluations and evaluators were not blinded to the treatment group. Conclusions Intralesional application of MGH to lacerations prior to wound closure may be beneficial in preventing infection and dehiscence. Larger, blinded studies focusing on wounds at a specific location with more objective assessment should be pursued.

Treating severe wounds in pediatrics with medical grade honey: A case series

“…Together, these characteristics make MGH effective against a broad range of microorganisms, including those resistant against antibiotics . MGH can serve as an alternative or complementary treatment for antibiotics in local infections, but also its prophylactic use has been demonstrated . Moreover, MGH has pro‐healing effects, keeps the wound moisturized, promotes autolytic debridement, has anti‐inflammatory and antioxidative effects, and induces angiogenesis and reepithelialization .…”

“…3 MGH can serve as an alternative or complementary treatment for antibiotics in local infections, but also its prophylactic use has been demonstrated. 12 Moreover, MGH has pro-healing effects, keeps the wound moisturized, promotes autolytic debridement, has anti-inflammatory and antioxidative effects, and induces angiogenesis and reepithelialization. 1,2,[13][14][15] Honey also contains protective molecules such as phenolic compounds and flavonoids that further enhance wound healing.…”

In vitro antimicrobial efficacy of two medical grade honey formulations against common high‐risk meticillin‐resistant staphylococci and Pseudomonas spp. pathogens

“…42 In a randomized controlled trial with 127 horses having lacerations, MGH1 was able to prevent infections and improve complete healing and veterinarian satisfaction. 43 Infected wounds often contain polymicrobial pathogens 44,45 and therefore an antimicrobial agent active against a wide spectrum of pathogens is warranted. The broad response of almost all the isolates tested in the present work against both MGHs suggests that they might have therapeutic efficacy in a variety of pathologies and that it should be considered for treatment of wounds and otitis externa.…”

Antibacterial and Antivirulence Activity of Manuka Honey against Genetically Diverse Staphylococcus pseudintermedius Strains

“…In parallel, manuka honey has been utilised by on October 29, 2020 by guest http://aem.asm.org/ Downloaded from the veterinary community, in particular for treatment of equine wounds [16]. Previous work has demonstrated in vitro activity against a wide range of equine bacterial isolates [17] with in vivo activity also recently reported [18].…”