Honey ---Debriding Alternative

Clinical Issue – Sharp debridement may not be an option for patients presenting with unstageable wounds and the impending loss of a pharmaceutical debrider served as a mobilizing factor in our quest to find a viable alternative to surgical and enzymatic debridement.    
Objective:  We began to examine choices in the marketplace that would allow debridement choices for those patients who would not be considered surgical candidates.  Whirlpool tubs had been removed from our hospital and the remaining enzymatic debrider was not offering us the results we sought.  Honey was reported in the literature as a potential debriding alternative and was chosen to see if the debriding activity would provide the results we desired in a wound—a clean granular tissue base.
Methods:  Selection criteria were fairly straight forward.  We selected patients who were not surgical candidates, had pressure ulcers that had not responded to an enzymatic debrider, and had the approval of physician, patient or health care proxy.  Patients and family members were overall quite agreeable as this product would not cause pain or bleeding as would be experienced with surgical or enzymatic debriders.  The honey dressings were applied either on top of or placed into a wound over non-viable tissue.  Absorbent dressings served as secondary dressings and wounds were changed every other day until drainage necessitated daily dressing changes.  Wound photography was obtained at the beginning of the study and on a weekly basis until treatment with the honey dressing was discontinued.
Results:  Patients reported no pain with this product and in each patient, the wounds showed improvement by the second or third dressing change.  Improvement was noted to be increasing amount of fresh viable tissue with a decreasing percentage of non-viable tissue present in the wound.  Nursing staff reported that the product was easy to use and apply