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EWMA2008
Presented at the
18 th Conference
of the European
Wound Management
Association,
14-16 May 2008,
Lisbon, Portugal
A Laboratory Survey of the
Antimicrobial Properties of
Honey-Containing Dressings
Abstract
Background: Many new sterile honey impregnated
wound dressings have recently become
available for clinical use. These dressings contain
different honey formulations, and therefore differing
antibacterial efficacy.
Aim: To investigate the antimicrobial properties of
six licensed wound dressings containing honey.
Method: 2 x 2 cm samples of each of six honey
containing dressings were applied to the surface
of bioassay plates seeded with overnight broth cultures
of bacteria. The organisms tested: Staphylococcus
aureus NCTC 6571, EMRSA-15 NCTC
13142 and a clinical isolate of Pseudomonas aeruginosa.
The plates were incubated at 37°C for 24
hours. Zones of inhibition were measured and
corrected zone sizes calculated, the plates were
prepared in duplicate on three separate occasions.
Results: Two dressings gave negligible zones of
inhibition with each of the three test organisms.
The remaining four dressings gave distinct zones
of inhibition with all organisms, staphylococci
were found to be more sensitive to honey than
pseudomonads.
Conclusion: The dressings that caused inhibition
of the test organisms all contained manuka honey
at relatively high concentrations. The dressings
that did not give rise to zones of inhibition contained
other honeys at lower concentrations. The
type and concentration of honey in wound dressings
influences efficacy in vitro.
INTRODUCTION
Honey has been used since ancient times as not
only a food source but also a medicinal product
and was used routinely in British hospitals up
until the 1970s, however with the advent of antibiotics
use of honey was reduced and eventually
lost from mainstream medicine. Since the advent
of antibiotic resistance there has been a growing
need for wound management products that can
act as an alternative to antibiotics 1 .
Honey has several advantages as a wound therapy
product, showing broad spectrum antimicrobial
activity against bacteria, protozoa and some
viruses 2-6 . It has also been reported to improve
wound healing, stimulate wound healing factors,
remove sloughy tissue and reduce wound odour 7-
9 . There are several reasons for the antimicrobial
action. Honey has a high sugar content leading
to high osmolarity in the wound, removing water
available for bacteria, and it also has a low pH
unsuitable for the growth of most wound infecting
pathogens. Some honeys generate hydrogen
peroxide on dilution in a wound and others contain
phytochemicals which may account for their
antimicrobial activity 10 .
Honey wound products have now been on the
market in the UK since 2004 and several brands
are available. Not all of the dressings produced are
the same; they can be made of differing materials:
gauze, tulle, mesh, polyethylenevinylacetate, alginate
or hydrogel. They contain different types of
honey such as Leptospermum honeys (manuka and
jelly bush), others use buckwheat or unspecified
honeys in their dressings. Some of the dressings
also contain formulations adding components
such as aloe vera and cod liver oil. These differing
products need comparative analysis to ensure that
informed decisions can be made when selecting
them for clinical practice.
METHODS
Test Organisms
n Staphylococcus aureus NCTC 6571
(Oxford staph)
n Epidemic methicillin-resistant Staphylococcus
aureus (EMRSA-15) NCTC 13142
n Pseudomonas aeruginosa (clinical isolate)
Science, Practice and Education
�
Rowena Jenkins
Neil Burton,
Rose Cooper,
University of Wales Institute
Cardiff
Corresponding author:
R. E. Jenkins,
Centre for Biomedical
Sciences,
Cardiff School of Health
Sciences,
University of Wales Institute
Cardiff,
Western Avenue,
Cardiff CF5 2YB
UK
r.jenkins7@uwic.ac.uk
EWMA Journal 2008 vol 8 no 3 11