PUBH6005 : Epidemiology PDF

Running head: Honey Treatment 1
The effectiveness of Honey in the Treatment of Bacterial Wound Infections
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Honey Treatment 2
Introduction
A wound is an interruption of the continuity of a tissue structure. Different forms of injuries
either caused by accident or surgery, results in tissue destruction, interference with blood
vessels, extravasation of blood components and hypoxia. Wounds can, therefore, occur at any
time be it at home, at work or in any other place. This requires that an immediate response is
made to prevent further microbial infection and bleeding. Honey has historically been used
for wound dressing in various settings. Honey is a natural substance produced from nectar
collected and changed by a variety of honeybees, especially the Apis mellifera. For instance,
one of the old text on surgery, Edwin Smith papyrus in the 2200 BC shows the healing of
head wound using a combination of oil and honey (Pećanac, Janjić, Komarčević, Pajić,
Dobanovački, & Skeledžija-Mišković, 2013). Ancient records from Egypt, Greece, and
Hippocrates among others report on the healing property of honey (Alves, Medeiros,
Albuquerque, & Rosa, 2013). Modern studies have reported on the clinical properties of
honey in the prevention of bacterial infections (Khalil, Khan, Ahmad, Khan, Khan, & Khan,
2013), and in the treatment of venous ulcers (Vandamme, Heyneman, Hoeksema, Verbelen,
& Monstrey, 2013).
Additionally, studies have demonstrated the effectiveness of honey in treating fatal wounds,
especially regarding the size and hygiene using bandages coated with honey (Yaghoobi &
Kazerouni, 2013). Likewise, Boateng and Catanzano (2015) have shown that honey
accelerates the rate of healing when applied in pressure wounds. The authors further confirm
that honey is vital in minimizing the foul odors that come from injuries; as an aspect that can
result in social isolation. The objective of this paper is to critically review five latest articles
that address the effectiveness of honey in dressing wounds with a view of providing most
recent information on the same and possible recommendations. It is expected that the review

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will answer the research question which is How effective is honey at treating bacterial wound
infections?
Methods
Search strategy
The researcher used search engines and databases such as Google Scholar, PubMed,
MEDLINE, and NCBI to search for relevant articles to be included in the study. The
keywords used include wound, honey, wound healing and wound care. The keywords were
searched in combination on the multiple databases under title, abstract or all fields. The
search was restricted to the articles published in English only and within the last seven years.
The researcher did not contact the authors for original data. The study was carried out
between October and November 2018. A total of 25 articles were obtained from the databases
after identification, screening and quality check. The twenty-five articles were then evaluated
and ten of them excluded due to duplication. Out of the fifteen remaining studies, ten of them
had no free access, and thus the researcher remained with five articles that fully met the
inclusion criteria. These comprised of four systematic reviews and one randomized control
trial (RCT). The articles were critiqued using the CASP checklist for systematic reviews and
RCTs.
Results
Yaghoobi and Kazerouni (2013) conducted a review of both RCTs and articles to ascertain
the evidence for the clinical use of honey in the healing of the wound. The adoption of a
systematic review is most appropriate because it enables the researcher to bring together
research and aid to ascertain commonalities and variations (Page et al., 2016). This is
significant in comprehensively answering the research question and in identifying research
gaps and making recommendations for future research.

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The study used a comparator and the review undertaken by three reviewers. This minimized
the possibility of evidence selection bias which could be as a result of missed articles by
either of the reviewers (Drucker Fleming, & Chan, 2016). Additionally, the inclusion of only
published articles will bias the systematic review of positive outcomes because the
unpublished articles are statistically non-significant (Dwan, Gamble, Williamson, &
Kirkham, 2013).
The study doesn’t have a confounding factor since only honey is reviewed concerning wound
healing. The review doesn’t also highlight any possible ethical issues considered while
selecting articles to be included in the study. This neglect compromises the quality of the
research since it included RCTs that dealt with humans and animals. Using grade
recommendations of FORM, the review can be graded to be of group C (Schünemann,
Brożek, Guyatt, & Oxman, 2013). This is because the study provides evidence for its
conclusion, however, caution has to be exercised in implementation because the authors
haven’t disclosed any inclusion and exclusion criteria, ethical issues and any possibility of
biases.
Stewart, McGrane, and Wedmore (2014) conducted a systematic review of the use of honey
in treating wounds in wilderness settings. The design is most appropriate for the study since it
is transparent in the manner in which the conclusions are made by avoiding the
misrepresentation of the knowledge base because each article is assessed and its quality and
application ascertained (Page et al., 2016). This ensures that the research question of
determining whether honey can be an effective improvised treatment in pre-hospital settings
is adequately answered.
The study has disclosed the search strategy including the databases and keywords. This
ensures that source and selection biases are minimized because the selection of articles for