Treating venous leg ulcers with honey dressings unlikely to help healing

When compared with normal care, treating a leg ulcer with dressings impregnated with honey did not significantly improve the rate of healing, but did lead to a significantly increased number of reported adverse events, according to research published today in the British Journal of Surgery.

The breakdown in skin tissue below the knee that ends in venous leg ulcers forming has been recognised for centuries. Since the 17th century it has been treated by applying a compression bandage and we now know that this helps the leg cope with the constant pressure of fluids in lower parts of the body (hydrostatic pressure).

The current interest in alternative medicines has led to renewed interest in honey as a potential healing agent, and some people have suggested using honey dressings as well as a compression bandage.

In a trial run in four centres around New Zealand (Auckland, South Auckland, Waikato and Christchurch), 368 patients were randomly divided into two groups. One was given conventional dressings, the other was given dressings impregnated with honey. Both groups had compression bandaging. After 12 weeks there was no significant difference between the rates of healing in the two groups. However, the honey treatment was more expensive, and people in that group reported significantly more adverse events than in the conventional group (111 vs 84 P=0.013).

“In our trial the honey dressing did not significantly improve healing, time to healing, change in ulcer area, incidence of infection or quality of life,” says lead author Dr Andrew Jull who works in the Clinical Trials Research Unit at the University of Auckland.

“The current focus of venous ulcer management should remain on compression and other treatments that have demonstrated that they improve compression's ability to work or prevent ulcer recurrence,” says Dr Jull.