Chap 3.indd

The challenge of wound care within the primary care setting relates to two key areas: healing or managing symptoms. While the objective would ideally be healing, chronic wound management hinges on managing symptoms. Honey has been used historically for its therapeutic properties, including, the promotion of rapid wound healing, reducing oedema, debriding necrotic tissue, reducing inflammation, stimulating tissue regeneration as a topical treatment for infected wounds (Molan, 2002; Vander Weyden, 2003), and can be effective on antibiotic resistant strains of bacteria (Molan, 1992; Cooper and Molan, 1999; Cooper et al, 1999; Dunford et al, 2000). Therefore, the effectiveness of honey should be judged on the purpose for the intervention, whilst acknowledging the additional components. Pure honey is a semi-translucent concentrated mixture of glucose, fructose, proteins, fatty acids, minerals, vitamins and water produced by worker bees from the nectar of flowers. Honey varies due to the pollen content and floral source from which it is obtained. Nectar is a weak natural sugar solution that the bees convert through enzymatic action into honey, which is stored in cells within the hive and covered with a thick waxy substance (beeswax) as a food store. Until now, honey has not been developed and specified as a wound management product, and has not been regulated by pharmaceutical or Medical Device standards. The first honey dressing available on FP10 (UK prescription) was ActivonTM tulle (Advancis Medical), which is a low adherent sterile dressing, impregnated with 20–25g of Manuka honey per 10 cm x 10 cm and 5–6g per 5 cm x 5 cm dressing. New dressings