Using Manuka Honey?

[woundnurse4u]

I have been tasked with evaluating other topical debriding products. Collagenase has been our go-to, but with the rising price, we are looking at a lower cost, yet equally effective option.

Has anyone integrated manuka honey products into their treatment recommendations? If so, how did you determine when to use manuka honey versus other treatment options?

I have reviewed some of the research. The research tends to veer to the antimicrobial properties of manuka honey and I haven't found as much that studied the debriding properties of the honey in comparative studies.

But I like the idea of the 1-2 punch (debridement and prevent/treat infection). I am also finding that I might need to develop or follow an algorithm (ie when would honey may not be as effective as collagenase).

So far, my results are mixed. I have had one patient complain about discomfort (persistent burning sensation), one patient who complained about pain but I didn't get to follow up due to discharge, and one patient who is responding to treatment as far as debridement but will likely require some adjunctive conservative excisional sharp debridement to help things along.

The honey impregnated foam dressing seems to be easier to work with versus the loose honey in a tube. Wear-time is also a question- are more frequent dressing changes optimal if infection is suspected or present? Or does that matter?

If a wound is highly exudative, the honey will become diluted (leading to a lessened effect on antimicrobial properties) and could require more frequent dressing changes. Any observations/suggestions are greatly appreciated.