Bed sores, also known as pressure ulcers, are localized injuries to the skin and underlying tissue that develop from prolonged pressure, usually over bony areas like the tailbone, heels, or hips. This sustained pressure restricts blood flow, causing tissue damage that can manifest as redness or a deep, open wound. Today, specialized, medical-grade honey is used as a complementary treatment option to help create a favorable environment for the healing of these complex injuries. This guidance informs the safe application of medical-grade honey to pressure ulcers, but it is not a substitute for professional medical assessment and ongoing care.
Understanding Medical-Grade Honey
Medical-grade honey differs significantly from the raw honey found on supermarket shelves because it is sterilized to remove bacterial spores and standardized for antimicrobial strength. The most commonly used variety is Manuka honey, sourced from the nectar of the Leptospermum scoparium tree in New Zealand and Australia. Manuka honey’s primary antimicrobial compound is Methylglyoxal (MGO), unlike other honeys that rely on hydrogen peroxide production.
The MGO concentration gives Manuka honey a non-peroxide activity (NPA) rating, which measures its efficacy against bacteria and is standardized for clinical use. The mechanism of action is multifaceted, beginning with the high sugar concentration that creates an osmotic effect. This effect draws fluid out of the wound bed, dehydrating bacteria, and the honey’s naturally low pH (3.2 to 4.5) creates an inhospitable environment for bacterial growth while supporting tissue oxygenation.
Medical-grade honey also aids in wound healing by promoting autolytic debridement, which is the body’s natural process of removing dead tissue. Its anti-inflammatory properties help reduce swelling and pain. By drawing fluid from the wound, the honey helps maintain a moist environment, which accelerates tissue repair and regeneration.
Applying Honey Dressings Step-by-Step
The application process must prioritize hygiene to prevent introducing new pathogens. Begin by washing your hands thoroughly and donning sterile gloves. First, cleanse the ulcer gently using a sterile saline solution to remove debris or wound exudate. The skin surrounding the wound should be patted dry, but the wound bed itself can remain slightly moist.
The medical-grade honey product, often a gel or paste, can be applied directly to the wound surface or onto a primary dressing material. If using a gel, aim for a layer about the thickness of a nickel, ensuring the honey fully covers the entire wound bed. Cover the tissue completely without applying so much excess product that it runs onto the healthy surrounding skin.
If the wound has a deep cavity or is irregularly shaped, saturate a primary dressing like sterile gauze or an alginate with the honey and carefully place it into the wound. Secure this primary dressing with a secondary, non-adherent, and preferably occlusive dressing to contain the honey and manage drainage. An occlusive dressing helps maintain the moist healing environment and prevents seepage.
The frequency of dressing changes depends on the amount of fluid the wound produces. For low-draining wounds, the dressing may be left in place for up to five to seven days. For wounds with moderate to heavy drainage, the dressing must be changed as soon as the secondary layer becomes saturated.
Monitoring the Wound and Safety Guidelines
Careful observation of the wound is necessary to ensure the honey treatment is supporting the healing process. Positive signs that the treatment is working include the development of healthy, pink or red granulation tissue, a noticeable reduction in any foul odor, and a gradual decrease in the wound’s overall size and depth.
Seek immediate professional medical attention if the patient develops systemic signs of infection, such as fever or chills. Localized warning signs requiring consultation include spreading redness or warmth around the wound edge, a significant increase in pain, or the presence of heavy yellow or green discharge. A mild, transient stinging sensation upon initial application is sometimes reported due to the honey’s low pH, but if this pain persists or is severe, the dressing should be removed and use discontinued.
Medical-grade honey is recommended for complementary use on Stage II and Stage III pressure ulcers, where it aids in debridement and healing. Its use on very deep, complicated wounds should always be managed under the direct supervision of a healthcare provider. If the wound appears to be getting larger or is not showing signs of improvement after several dressing changes, consult a physician for a re-evaluation of the treatment plan.