The use of medical grade honey to reduce the incidence of surgical wound infection : a randomised controlled feasibility trial

Robson, V

Abstract

Background: Patients having free tissue transfer for oral and oropharyngeal squamous
cell carcinoma are susceptible to MRSA. There are many strategies to reduce wound
infection rates such as hand washing policies antibiotics but NICE guidelines suggest that
research is necessary to find alternatives, such as the use of medical grade honey. To
date, no rigorous study on the use of honey to prevent wound infection has been reported.
Aim: To assess the feasibility of conducting a randomised controlled trial using
Leptospermum honey to reduce the incidence of wound infection following microvascular
free tissue reconstruction for head and neck cancer.
Method: 70 consecutive patients having free tissue reconstruction 56 (80%) consented to
be randomised and 49 (70%) were actually randomised. Twenty five received honey and
24 received conventional treatment. Data were collected between February 2008 and
March 2009.
Results: At seven days the honey group had more positive wound swabs compared to the
non-honey group 20% (5/25) v 13% (3/24) (p= 0.70) but at 28 days positive swab results
in the non-honey group had increased to 50% (12/24 v 8/25 (p = 0.25). No adverse events
were reported. Patients in the honey group spent significantly less time in hospital after
surgery (p = 0.02) representing a saving between 0.2 days and 11.2 days. Satisfaction
surveys showed that honey dressings were acceptable to both patients and nurses.
Discussion: The study indicated potential advantages in the application of honey as a
topical antimicrobial to wounds healing by primary intention in head and neck surgery
leading to improvement in length of stay. The dressings were equal in cost compared to
standard dressings in this area of care. The study provided a framework on which a large
multicentre trial can be based to provide a rigorous RCT on the use of honey as a
prophylaxis to wound infection in head and neck cancer.

• Thesis Type: Thesis
• Deposit Date: Aug 13, 2021
• Award Date: Jan 1, 2012