Honey/Maggots/Leccches. What Is the Evidence?

Honey
Medicinal functions of honey include stimulation of wound healing and antimicrobial properties. Honey has been show to increase the release of cytokine TNF-alpha from macrophages and TNF-α, IL-1L, TGF-ß, amd MMP-9 ctytokines from keratinocytes. It also stimulates wound re-epithelizalization. Through synergistic action of sugar, hydrogen peroxide, methylglyoxal, and defensing-1, it also kills antibiotic-resistant bacteria, such as methicillin resistant Staphylococcus aureus (MRSA). Antimicrobial and antioxidant properties of honey are influenced by the plant species on which the honeybees feed.

Honey’s osmotic properties draw fluid from the wound, keeping the wound bed moist while reducing the risk of maceration. Via anti-inflammatory processes, it reduces exudate and inhibits fibrin formation. Results of studies in people are variable. In one randomized, controlled, double blind study, wound healing after toenail surgery was similar with honey coated and conventional paraffin dressings. In another study, wound healing with honey was delayed, compared with conventional iodine dressing, in patients that underwent toenail avulsion surgery. Uncontrolled case series also provided variable results. In one study of people with chronic leg wounds, a 50% reduction in size was seen after one month of treatment with a honey bandage. In other studies, use of honey resulted in no difference in rate of wound healing, as compared with calcium alginate dressing, or increased rate of wound healing, when compared with a conventional hydrogel dressing. In studies of abdominal incision infections, honey resulted in faster time to healing (6 days) as compared with iodine/alcohol antiseptic treatment (15 days). Unfortunately, most studies of use of honey for treatment of infected wounds in people were of low quality. In the case of burns, randomized controlled studies showed that treatment with honey resulted in a significantly shorter time to healing (7-11 days) as compared with silver sulfadiazine (13 days) or polyurethane film (15 days). Systematic reviews conclude that honey induces more rapid healing times in mild-to-moderate superficial and partial thickness burns as compared with conventional dressings. [...]