Supportive Care in Cancer

, Volume 14, Issue 1, pp 91–97 | Cite as

Wound care with antibacterial honey (Medihoney) in pediatric hematology–oncology

  • Arne SimonEmail author
  • Kai Sofka
  • Gertrud Wiszniewsky
  • Gisela Blaser
  • Udo Bode
  • Gudrun Fleischhack
Short Communication


The physiologic process of wound healing is impaired and prolonged in pediatric patients receiving chemotherapy. Due to profound immunosuppression, wound infection can easily spread and act as the source of sepsis. Referring to in vitro studies, which confirmed the antibacterial potency of special honey preparations against typical isolates of nosocomially acquired wound infections (including Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant enterococci) and considering the encouraging reports from other groups, Medihoney has now been used in wound care at the Department of Pediatric Oncology, Children’s Hospital, University of Bonn for 3 years. Supplemented with clinical data from pediatric oncology patients, this article reviews the scientific background and our promising experience with Medihoney in wound care issues at our institution. To collect and analyze the available experience, we prepare an internet-based data documentation module for pediatric wound care with Medihoney.


Wound care Pediatric oncology Honey MRSA 


  1. 1.
    Larson E, Nirenberg A (2004) Evidence-based nursing practice to prevent infection in hospitalized neutropenic patients with cancer. Oncol Nurs Forum 31(4):717–725PubMedGoogle Scholar
  2. 2.
    Kostler WJ, Hejna M, Wenzel C, Zielinski CC (2001) Oral mucositis complicating chemotherapy and/or radiotherapy: options for prevention and treatment. CA Cancer J Clin 51(5):290–315PubMedGoogle Scholar
  3. 3.
    Edwards R, Harding KG (2004) Bacteria and wound healing. Curr Opin Infect Dis 17(2):91–96CrossRefPubMedGoogle Scholar
  4. 4.
    Wysocki AB (2002) Evaluating and managing open skin wounds: colonization versus infection. AACN Clin Issues 13(3):382–397PubMedGoogle Scholar
  5. 5.
    Al-Waili NS (2004) Investigating the antimicrobial activity of natural honey and its effects on the pathogenic bacterial infections of surgical wounds and conjunctiva. J Med Food 7(2):210–222CrossRefPubMedGoogle Scholar
  6. 6.
    Gardner SE, Frantz RA, Doebbeling BN (2001) The validity of the clinical signs and symptoms used to identify localized chronic wound infection. Wound Repair Regen 9(3):178–186CrossRefPubMedGoogle Scholar
  7. 7.
    Zaghloul AA, el-Shattawy HH, Kassem AA, Ibrahim EA, Reddy IK, Khan MA (2001) Honey, a prospective antibiotic: extraction, formulation, and stability. Pharmazie 56(8):643–647PubMedGoogle Scholar
  8. 8.
    Ahmed AK, Hoekstra MJ, Hage JJ, Karim RB (2003) Honey-medicated dressing: transformation of an ancient remedy into modern therapy. Ann Plast Surg 50(2):143–147; discussion 7–8CrossRefPubMedGoogle Scholar
  9. 9.
    Cooper RA, Molan PC, Harding KG (1999) Antibacterial activity of honey against strains of Staphylococcus aureus from infected wounds. J R Soc Med 92(6):283–285PubMedGoogle Scholar
  10. 10.
    Cooper RA, Molan PC, Krishnamoorthy L, Harding KG (2001) Manuka honey used to heal a recalcitrant surgical wound. Eur J Clin Microbiol Infect Dis 20(10):758–759CrossRefPubMedGoogle Scholar
  11. 11.
    Molan PC, Betts JA (2004) Clinical usage of honey as a wound dressing: an update. J Wound Care 13(9):353–356PubMedGoogle Scholar
  12. 12.
    Namias N (2003) Honey in the management of infections. Surg Infect (Larchmt) 4(2):219–226CrossRefGoogle Scholar
  13. 13.
    Dunford C, Cooper R, Molan P (2000) Using honey as a dressing for infected skin lesions. Nurs Times 96(14 Suppl):7–9Google Scholar
  14. 14.
    Dunford CE, Hanano R (2004) Acceptability to patients of a honey dressing for non-healing venous leg ulcers. J Wound Care 13(5):193–197PubMedGoogle Scholar
  15. 15.
    Honari S (2004) Topical therapies and antimicrobials in the management of burn wounds. Crit Care Nurs Clin North Am 16(1):1–11CrossRefPubMedGoogle Scholar
  16. 16.
    Merz J, Schrand C, Mertens D, Foote C, Porter K, Regnold L (2003) Wound care of the pediatric burn patient. AACN Clin Issues 14(4):429–441PubMedGoogle Scholar
  17. 17.
    Subrahmanyam M (1999) Early tangential excision and skin grafting of moderate burns is superior to honey dressing: a prospective randomised trial. Burns 25(8):729–731CrossRefPubMedGoogle Scholar
  18. 18.
    Subrahmanyam M (1993) Honey impregnated gauze versus polyurethane film (OpSite) in the treatment of burns—a prospective randomised study. Br J Plast Surg 46(4):322–323CrossRefPubMedGoogle Scholar
  19. 19.
    Subrahmanyam M (1991) Topical application of honey in treatment of burns. Br J Surg 78(4):497–498PubMedGoogle Scholar
  20. 20.
    Al-Waili NS (2001) Therapeutic and prophylactic effects of crude honey on chronic seborrheic dermatitis and dandruff. Eur J Med Res 6(7):306–308PubMedGoogle Scholar
  21. 21.
    Al-Waili NS (2004) Topical honey application vs. acyclovir for the treatment of recurrent herpes simplex lesions. Med Sci Monit 10(8):MT94–MT98PubMedGoogle Scholar
  22. 22.
    Abenavoli FM, Corelli R (2003) Honey cream. Ann Plast Surg 50(1):105–106CrossRefPubMedGoogle Scholar
  23. 23.
    Subrahmanyam M (1993) Storage of skin grafts in honey. Lancet 341(8836):63–64CrossRefGoogle Scholar
  24. 24.
    Molan PC, Allen KL (1996) The effect of gamma-irradiation on the antibacterial activity of honey. J Pharm Pharmacol 48(11):1206–1209PubMedGoogle Scholar
  25. 25.
    Moore G, Smith L, Campbell F, Seers K, McQauy H, Moore H (2001) Systematic review of the use of honey as a wound dressing. BMC Complement Altern Med 1(2 (4 June 2001)):
  26. 26.
    Bang LM, Buntting C, Molan P (2003) The effect of dilution on the rate of hydrogen peroxide production in honey and its implications for wound healing. J Altern Complement Med 9(2):267–273CrossRefPubMedGoogle Scholar
  27. 27.
    Tonks AJ, Cooper RA, Jones KP, Blair S, Parton J, Tonks A (2003) Honey stimulates inflammatory cytokine production from monocytes. Cytokine 21(5):242–247CrossRefPubMedGoogle Scholar
  28. 28.
    Cooper R, Molan P (1999) The use of honey as an antiseptic in managing Pseudomonas infection. J Wound Care 8(4):161–164PubMedGoogle Scholar
  29. 29.
    Cooper RA, Halas E, Molan PC (2002) The efficacy of honey in inhibiting strains of Pseudomonas aeruginosa from infected burns. J Burn Care Rehabil 23(6):366–370CrossRefPubMedGoogle Scholar
  30. 30.
    Cooper RA, Molan PC (1999) Honey in wound care. J Wound Care 8(7):340PubMedGoogle Scholar
  31. 31.
    Cooper RA, Molan PC, Harding KG (2002) The sensitivity to honey of Gram-positive cocci of clinical significance isolated from wounds. J Appl Microbiol 93(5):857–863CrossRefPubMedGoogle Scholar
  32. 32.
    Simon A, Fleischhack G, Hasan C, Bode U, Engelhart S, Kramer MH (2000) Surveillance for nosocomial and central line-related infections among pediatric hematology–oncology patients. Infect Control Hosp Epidemiol 21(9):592–596PubMedGoogle Scholar
  33. 33.
    Lubbe J (2003) Secondary infections in patients with atopic dermatitis. Am J Clin Dermatol 4(9):641–654PubMedGoogle Scholar
  34. 34.
    Ricci G, Patrizi A, Neri I, Bendandi B, Masi M (2003) Frequency and clinical role of Staphylococcus aureus overinfection in atopic dermatitis in children. Pediatr Dermatol 20(5):389–392CrossRefPubMedGoogle Scholar
  35. 35.
    Alarcon A, Pena P, Salas S, Sancha M, Omenaca F (2004) Neonatal early onset Escherichia coli sepsis: trends in incidence and antimicrobial resistance in the era of intrapartum antimicrobial prophylaxis. Pediatr Infect Dis J 23(4):295–299PubMedGoogle Scholar
  36. 36.
    Kramer A, Daeschlein G, Kammerlander G, Abdriessen A, Aspöck C, Bergemann R et al (2004) Consensus recommendation for the choice of antiseptic agents in wound care (Article in German). Hyg Med 29(5):147–157Google Scholar
  37. 37.
    Reimer K, Wichelhaus TA, Schafer V, Rudolph P, Kramer A, Wutzler P et al (2002) Antimicrobial effectiveness of povidone-iodine and consequences for new application areas. Dermatology 204(Suppl 1):114–120CrossRefPubMedGoogle Scholar
  38. 38.
    Subrahmanyam M (1998) A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Burns 24(2):157–161CrossRefPubMedGoogle Scholar
  39. 39.
    Molan P, Betts J (2000) Using honey dressings: the practical considerations. Nurs Times 96(49):36–37Google Scholar
  40. 40.
    Molan PC (2002) Re-introducing honey in the management of wounds and ulcers—theory and practice. Ostomy/Wound Manage 48(11):28–40Google Scholar
  41. 41.
    Molan PC (1999) The role of honey in the management of wounds. J Wound Care 8(8):415–418PubMedGoogle Scholar
  42. 42.
    Johnson DW, van Eps C, Mudge DW, Wiggins KJ, Armstrong K, Hawley CM et al (2005) Randomized, controlled trial of topical exit-site application of honey (Medihoney) versus mupirocin for the prevention of catheter-associated infections in hemodialysis patients. J Am Soc Nephrol 16:1456–1462CrossRefPubMedGoogle Scholar
  43. 43.
    Biswal BM, Zakaria A, Ahmad NM (2003) Topical application of honey in the management of radiation mucositis: a preliminary study. Support Care Cancer 11(4):242–248PubMedGoogle Scholar
  44. 44.
    Vardi A, Barzilay Z, Linder N, Cohen HA, Paret G, Barzilai A (1998) Local application of honey for treatment of neonatal postoperative wound infection. Acta Paediatr 87(4):429–432CrossRefPubMedGoogle Scholar
  45. 45.
    Lehrnbecher T, Marshall D, Gao C, Chanock SJ (2002) A second look at anorectal infections in cancer patients in a large cancer institute: the success of early intervention with antibiotics and surgery. Infection 30(5):272–276CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Arne Simon
    • 1
    Email author
  • Kai Sofka
    • 1
  • Gertrud Wiszniewsky
    • 1
  • Gisela Blaser
    • 1
  • Udo Bode
    • 1
  • Gudrun Fleischhack
    • 1
  1. 1.Department of Pediatric Hematology and Oncology, Children’s HospitalUniversity of BonnBonnGermany

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