Bacteriological changes in sloughy venous leg ulcers treated with manuka honey or hydrogel: an RCT

J Wound Care. 2008 Jun;17(6):241-4, 246-7. doi: 10.12968/jowc.2008.17.6.29583.


Objective: To determine the qualitative bacteriological changes that occurred during a four-week treatment period with either manuka honey or a hydrogel dressing. This was the secondary outcome of a randomised controlled trial (RCT) that compared the efficacy of the two treatments in desloughing venous leg ulcers.

Method: This was a prospective open label multicentre RCT with blinded microbiological outcome analysis. Randomisation was conducted via remote telephone. To be included, the wound bed needed to comprise at least 50% slough. Wound swabs were taken at the start of treatment and after four weeks.

Results: In all, 108 patients (35 males, 73 females) aged 24-89 years (mean 68) enrolled into the study. Both groups were comparable at baseline. Eighteen patients (17%) were withdrawn due to a wound infection: six in the honey group and 12 in the hydrogel group. Staphylococcus aureus was the most common isolate, being identified in 41 wounds (38%). At baseline, meticillin-resistant Staphylococcus aureus was identified in 16 wounds (10 honey versus six hydrogel). After four weeks 70% (n=7) of the manuka-honey treated wounds versus 16% (n=1) of the hydrogel treated wounds had MRSA eradicated. Pseudomonas aeruginosa was reported in 14% (n=16) of all wounds at baseline. After four weeks 33% (n=2) treated with honey and 50% (n=5) treated with hydrogel had this eliminated. The number of wounds (n=11 at baseline; n=15 at week 4) with > or =3 bacteria species remained constant over the four weeks.

Conclusion: Manuka honey was effective in eradicating MRSA from 70% of chronic venous ulcers. The potential to prevent infection is increased when wounds are desloughed and MRSA is eliminated. This can be beneficial to prevent cross-infection.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bandages, Hydrocolloid*
  • Debridement / methods
  • Female
  • Honey*
  • Humans
  • Leptospermum
  • Male
  • Methicillin Resistance
  • Middle Aged
  • Prospective Studies
  • Pseudomonas Infections / microbiology
  • Pseudomonas Infections / prevention & control
  • Pseudomonas aeruginosa
  • Single-Blind Method
  • Skin Care
  • Staphylococcal Skin Infections / microbiology
  • Staphylococcal Skin Infections / prevention & control
  • Staphylococcus aureus
  • Treatment Outcome
  • Varicose Ulcer / complications*
  • Varicose Ulcer / pathology
  • Wound Healing
  • Wound Infection / microbiology
  • Wound Infection / prevention & control*