July 23, 2008

Honey Merits Questioned

I FULLY agree with Dr Mosquera that compression bandaging is the proven, effective treatment for venous ulcers, and I would never suggest that it not be used. In all the clinical work in which I have collaborated, honey has always been used in conjunction with compression bandaging.

I am sure that Dr Mosquera will have experienced himself that a proportion of cases of leg ulcers do not heal despite compression bandaging being used.

In the pilot trial that was carried out by community nurses based at Waikato Hospital, it was only patients with non- healing venous ulcers that were recruited. Honey was found to be very effective in healing these ulcers.

The findings of this pilot trial, however, do not provide scientific proof of honey being effective -- a randomised comparative trial on a larger number of patients would be required for scientific proof to be obtained.

Such a trial would be warranted on the basis of the results from the pilot trial and the evidence from many case reports.

The HALT trial did not select patients with non-healing ulcers. It was designed to find if honey was effective as an additional component in the routine treatment of routine venous ulcers. The prognostic score of the patients recruited indicated that 46% of the patients recruited were expected to heal normally with compression bandaging.

The remaining 54% of patients, with whom problems in healing could be expected to be experienced with compression bandaging alone, was too small a number to expect to see a statistically significant benefit from using honey dressings.

It is commonly the case that patients with non-healing venous ulcers have diabetes (poor wound healing is a feature of diabetes). Diabetics were excluded from the HALT trial. The results of a clinical trial in Northern Ireland on using honey on venous ulcers will be published soon. In this trial diabetics were included.

A statistically significant improvement in the rate of healing with honey was found in this trial. Dr PETER MOLAN

Professor in Biological Sciences & Director of the Honey Research Unit, University of Waikato

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