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Science

Science

Why Clinicians are Switching to Honey?

Clinicians continuously search to find reliable, effective advanced treatment options for the more than 7 million patients in need of chronic wound care treatment – many of whom are also suffering from complex, comorbid diseases and if the wound does not resolve and close are at risk of lower extremity amputation.

Evidence continues to grow as increasing numbers of patients dealing with complex or non-healing wounds who have not responded to traditional products are responding to ManukaMed products.

Reasons for Non-Healing or Stalled Wounds

  • Necrotic Tissue Present
  • Non-resolving inflammation
  • Bio film formation and bacterial infection
  • High levels of proteases
  • Impaired perfusion and decreased tissue oxygenation
  • Oxidative stress

 

The Power of Medical Grade Manuka Honey

Medical Grade Manuka Honey has been used since ancient times to manage non-healing wounds and has recently been rediscovered by medical researchers for its unique and powerful ability to attack the elements that prevent wound healing.

Medical Grade Manuka Honey Heals Wounds Four Ways

1. Lowers pH in the Wound Bed

Chronic, non-healing wounds have an elevated alkaline environment. Lowering the wound pH reduces protease activity, increases fibroblast activity, and increases oxygen release. (1)

How it Works

Optimizes healing conditions in the wound bed

Digestive enzymes may be destroying newly repaired tissue and growth factors needed to stimulate the growth of the tissue. These enzymes only operate at a neutral pH. Manuka honey’s pH level of 3.5-4.5 reduces protease activity by deactivating these digestive enzymes.

 

By reducing protease activity, Manuka honey naturally increases the release and activation of growth factors and tissue growth, helping “good” cells move into the proliferation phase. (2)

Inhibits bacterial growth

Not only is bacteria unable to grow in an acidic environment, but Manuka honey’s viscous consistency provides protection of open wounds to help prevent bacteria getting into them. (6)

 

2. Creates Antimicrobial Activity

A large amount of evidence from clinical trials demonstrate the effectiveness of honey in clearing infection in wounds.

CASE STUDY: Variable Antimicrobial Activity of Three Different Medical Manuka Honeys Against MRSA in vitro

In addition to bacteria clearing effectiveness, Manuka honey is becoming an attractive alternative to traditional infection control methods because of the low chance of bacterial resistance to honey. (6)

How it Works

All honeys create antibacterial activity, due primarily to the hydrogen peroxide formed in a “slow release” manner by the enzyme glucose oxidase present in honey. The native New Zealand Manuka bush (Leptospermum Scoparium) is known to contain a special property, Methylglyoxal [link to What is MGO?], an antibacterial component chemical marker that distinguishes antimicrobial potency levels.

Manuka honey is also unique in that it is the only type of honey to have significant anti-bacterial response called Non-Peroxide Activity (NPA). The NPA is not affected by the catalase enzyme present in wound fluid which, in other honeys, will rapidly break down the major antibacterial factor of hydrogen peroxide. The NPA in Manuka honey does not decompose in the presence of catalase, leaving a more stable environment for healing. (3)

3. Creates an Anti-Inflammatory Response

Medical Grade Manuka honey at a concentration of 5% has an anti-inflammatory effect equivalent to that of 5 mg/ml of hydrocortisone, a commonly prescribed anti-inflammatory drug. By inhibiting the prostaglandin synthesis, Manuka honey reduces inflammatory responses such as heat, itchiness, and pain. (4)

How it Works

In clinical studies, there has been direct evidence of anti-inflammatory activity obtained in the form of decreased levels of amlondialdehyde and a reduced lenkocyte count. The MGO found in Manuka honey is a highly reactive compound that irreversibly modifies proteins, which leads to the reduced activation of inflammatory cells. However, if was found that Manuka honey increased pro-inflammatory cytokines, indicating that Manuka honey allowed inflammation to proceed at a modulated level, allowing healing to continually occur. (4)

4. Debrides more rapidly than modern debriding agents

 

Honey has been used as a debriding agent since ancient times and has recently been rediscovered. Its effectiveness has been compared to that of modern debriding agents, and honey has been found to work more rapidly than all except larval therapy. (5) 

In addition to removing slough and necrosis, Manuka honey immediately halts the spreading necrosis and debrides the wound (5). This is very important to the wound healing process as necrotic tissue delays wound healing by supporting bacterial growth and reducing the clinician’s ability to adequately assess the depth of the wound. 
 

How it Works

Medical Grade Manuka honey removes attached slough, necrotic tissue, and eschar by facilitating autolytic debridement. By creating a moist environment, the high sugar content is able to cause constant osmotic withdrawal of fluid from the wound bed, which is replaced by underlying circulation. The high sugar content’s stimulatory action on proteases aides in autolytic debridement. (5)

The high osmolarity action of Manuka honey draws moisture from the skin surrounding the wound preventing maceration. The active process of osmolarity rapidly decreases edema improving blood flow to the tissue, and promotes autolytic and mechanical debridement by creating a constant flow of lymph fluid. 

Lymph fluid contains plasmogen. Manuka honey has been found to block the Plasminogen Activator Inhibitor (PAI) allowing plasmogen to convert into active plasmin, which breaks down the fibrin clots holding slough and necrotic tissue to the wound bed. 
 

It is important to have a super absorbent wound dressing in conjunction with honey so honey remains present on the wound bed when there is substantial exudate from the wound. MANUKAhd, MANUKAhd Lite, and MEDSAF placed over MAN UKApli, all absorb exudate while releasing a sustained flow of honey into the wound bed. 

Slough and necrotic tissue are removed with the bandage. The painless removal of grit embedded in wounds is due to the moist wound environment created by honey. (5) 
 

 

References: 

  1. Molan, P. (2012). Why honey works well in healing wounds (pp. 1-3). N.p.: Academia.edu.
  2. Gethin, G., Cowman, S., & Conroy, R. (n.d.). The impact of Manuka honey dressings on the surface pH of chronic wounds. Dublin, Ireland: Research CEntre, Faculty of Nursing and Midwifery, Royal College of Surgeons, Irelan (RCSI).
  3. Molan, P. (2012). What's special about Active Manuka Honey (pp. 1-4). N.p.: Academia.edu.
  4. Bean, A. (2012). Investigating the Anti-inflammatory Activity of Honey (Master's thesis).
  5. Molan, P. (2009, July). Journal of Wound Technology, 5, 12-16.
  6. Molan, P. (2012). The antibacterial activity of honey and its role in treating diseases (p. 13). N.p.: Academia.edu.