Honey for wound healing.
Can honey be used to treat wounds from cancer surgery?
The answer is probably 'Yes'. Honey has been used for many years by country people to heal wounds, as it is known to have anti-bacterial properties. Now however, research is showing that honey may also have anti-tumour properties:
DNC News: Honey, wound healing and cancer surgery
Subject: Topical honey on surgical wounds speeds healing and impedes tumor implantation
Sometime I research and write these articles in order to persuade other physicians to accept the unconventional method of treatment their patients have chosen or desire. The suggestion in this article, although legitimate and made in good faith, may not go over well with your surgeon.
Surgical wounds, especially cancer surgical wounds, and most especially infected wounds should be treated with topical honey.One of the problems with treating cancer surgically is that once the tumor is cut open it can spread and cancerous cells can migrate to new locations and implant themselves. Surgical wounds where the tissue has been injured are good sites for these cancer cells to implant. Tumor implantation (TI) is a special concern in laparoscopic surgeries where, although the openings are relatively small, all the instruments used in the surgery come in close contact with the wound. As laparoscopic surgery becomes more commonly used, TI becomes a greater concern
Several approaches have been tried to reduce tumor implantation. In one experiment, researchers excised the borders of the wounds before closing the openings. Others have experimented with bathing the surgical instruments in various anticancer chemicals. The most interesting approach tried is coating the wounds with honey. In a study published in 2000 in the Archives of Surgery, Turkish researchers described how they made neck wounds in 60 mice and inoculated the wounds with cancer cells. Half of the wounds they coated with honey. Ten days later all of the control mice who were NOT treated with honey had obvious palpable tumors growing at the wound site. Of the honey treated mice, not one had a visible tumor. On microscopic examination 8 of the 30 were found to have tiny tumors.
Ignoring the difference in size, honey reduced implantation of cancer cells form 30/30 to 8/30. This prompted the researchers to write, “Honey could be used as a wound barrier against TI during pneumoperitoneum in laparoscopic oncological surgery and in other fields of oncological surgery.” [1] Compare this study with one from 1998 in which tumoricidal chemicals were used to treat the instruments to reduce tumor implantation at the wound sites. This earlier study used hamsters instead of mice but followed a similar model. [2]
This chemical treatment produced an 18% reduction in tumor implantation. Compare that to the 73% reduction from honey. Experiments using surgical excision of the wound borders also reduced implantation but produced even poorer results. Cutting away the tissue reduced implantation rates by only 9%. [3] Now these studies were not exactly identical and I shouldn’t compare the results but the results from the honey are certainly interesting.
When you consider that the chemically coated instruments produced an 18% reduction, the excisions a 9% reduction and the honey a 73% reduction, the idea of coating surgical wounds after cancer surgery shouldn’t be laughed at.Two quick diversions while I am thinking about them:
First, honey inhibits the growth of bladder cancer cells in vitro (test tube) and in vitro (live critters). It inhibits the growth of tumors when injected into the tumor and also when simply given orally (fed) to mice. [4]
Second, researchers in Poland have taken a cancer fighting chemical from broccoli, sulforaphane, fed it to honey bees and produced honey with very high concentrations of sulforaphane. [5] OK back to the main discussion.
Assuming that these results are correct and honey reduced the risk of spreading cancer tumors during surgery; my first thought is still, “yucch!” Wouldn’t honey increase the risk of the wound getting infected? This is not the case and the opposite is in fact true. Honey has a long history of use in healing wounds and treating infection from ancient to modern times. I was surprised at how much research a quick review turned up. I found several animal studies in which the effect of honey on wound healing was measured. They point to faster wound healing and less infection. One looked at wound healing in mice [6] and two other looked at rabbits. [7,8]
All found that topical application of honey to the site of surgical wounds improved the healing process.
The human studies are far more interesting for a number of reasons. First they deal with people not furry animals so there is no need to wonder if the results can be applied to our species. Second, because they are looking at infected wounds. Third because they look at two groups of people we usually consider more sensitive to harmful side effects, women and children. The following is the abstract from a clinical trial on infants with non healing infected wounds published in 1998.
“…… In this report we present our experience in nine infants with large, open, infected wounds that failed to heal with conventional treatment. Conventional treatment was defined as having failed if after 14 days or more of intravenous antibiotic and cleaning the wound with chlorhexidine 0.05% W/V in aqueous solution and fusidic acid ointment the wound was still open, oozing pus, and swab cultures were positive. All infants showed marked clinical improvement after 5 days of treatment with topical application of 5-10 ml (1-2 teaspoons) of fresh unprocessed honey twice daily. The wounds were closed, clean and sterile in all infants after 21 days of honey application. There were no adverse reactions to the treatment. We conclude that honey is useful in the treatment of post-surgical wounds that are infected and do not respond to conventional systemic and local antibiotic treatment”. [9]
Another study looked at the effect of honey on women who had infected wounds following C-section. All women were >treated with systemic antibiotics but 26 women had honey applied topically while the control group had topical iodine and antibiotics instead. The honey treated women cleared their infections in half the time, an average of 6 days compared to 15 days for the control group. Their scars were less than half the size. Average hospital stay was 9 days compared to 20 days. The authors write, “We concluded that topical application of crude undiluted honey could (1) produce faster eradication of bacterial infections, (2) reduce period of antibiotic use and hospital stay, (3) accelerate wound healing, (4) prevent wound dehiscence and need for re-suturing and (5) result >in minimal scar formation.” [10]
Looking at this information suggests an obvious conclusion. We should be using honey on surgical wounds. Patients about to undergo surgery should ask their surgeons if they can apply honey to their wounds post-op. Protocols in the human studies have varied from twice a day to every hour. Raw honey was used in all the studies. Honey seems especially indicated when wounds become infected or fail to close or heal. It is probably even more indicated on the wounds left by laparoscopic surgery to remove cancer.
If (or when) your surgeon objects to your using honey, ask her why. Is the reason they come up with as persuasive as the ones in favor? I’m curious.
References
1. Arch Surg. 2000 Dec;135(12):1414-7Protective covering of surgical wounds with honey impedes tumor implantation.Hamzaoglu I, Saribeyoglu K, Durak H, Karahasanoglu T, Bayrak I, Altug T, Sirin F, Sariyar M.
2. J Surg Oncol. 1998 Sep;69(1):9-13; discussion 14.
Local treatment of abdominal wound reduces tumor implantation.Wu JS, Pfister SM, RuizMB, Connett JM, Fleshman JW.
3. Dis Colon Rectum. 1998 Sep;41(9):1107-11. Excision of trocar sites reduces tumor implantation in an animal >model.Wu JS, Guo LW, Ruiz MB, Pfister SM, Connett JM, Fleshman JW.
4. Int J Urol. 2003 Apr;10(4):213-9. Antineoplastic activity of honey in an experimental bladder cancer implantation model: in vivo and in vitro studies. Swellam T, Miyanaga N, Onozawa M, Hattori K, Kawai K, Shimazui T, Akaza H.
5. Rocz Panstw Zakl Hig. 2003;54(1):25-32 [Herb honey containing sulforaphane-aglycone with potential use in cancer prophylaxis] Swiderski A, Sterkowicz P, Kaszycki P, Koloczek H
6. Am J Surg. 1983 Mar;145(3):374-6. Acceleration of wound healing by topical application of honey. An animal model.Bergman A, Yanai J, Weiss J, Bell D, David MP.
7. Zentralbl Veterinarmed A. 1998 Apr;45(3):181-8 Effects of topical application of honey on cutaneous wound healing in rabbits. Oryan A, Zaker SR.
8. Eur J Obstet Gynecol Reprod Biol. 2002 Sep 10;104(2):152-5. The role of intra-peritoneal honey administration in preventing post-operative peritoneal adhesions. Aysan E, Ayar E, Aren A, Cifter C.
9. Acta Paediatr. 1998 Apr;87(4):429-32. Local application of honey for treatment of neonatal postoperative wound infection. Vardi A, Barzilay Z, Linder N, Cohen HA, Paret G, Barzilai A.
10. Eur J Med Res. 1999 Mar 26;4(3):126-30 Effects of topical honey on post-operative wound infections due to gram positive and gram negative bacteria following caesarean sections and hysterectomies. Al-WailiNS, SaloomKY.