Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing

Diabetic foot ulcers (DFUs) are considered a major problem for public health, leading to high rates of lower-limb amputations. Moreover, due to the high prevalence rate of predisposing factors, the incidence rate of DFU is still rising. Although DFUs are complex in nature, foot ulceration usually pr...

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Main Authors: Andrea Bezerra, Hélder Fonseca, Francisca Rodrigues, Cristina Delerue-Matos, Irene Gouvinhas, Juliana Garcia
Format: Article
Language:English
Published: MDPI AG 2023-11-01
Series:Applied Sciences
Subjects:
Online Access:https://www.mdpi.com/2076-3417/13/23/12820
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author Andrea Bezerra
Hélder Fonseca
Francisca Rodrigues
Cristina Delerue-Matos
Irene Gouvinhas
Juliana Garcia
author_facet Andrea Bezerra
Hélder Fonseca
Francisca Rodrigues
Cristina Delerue-Matos
Irene Gouvinhas
Juliana Garcia
author_sort Andrea Bezerra
collection DOAJ
description Diabetic foot ulcers (DFUs) are considered a major problem for public health, leading to high rates of lower-limb amputations. Moreover, due to the high prevalence rate of predisposing factors, the incidence rate of DFU is still rising. Although DFUs are complex in nature, foot ulceration usually precedes diabetic foot amputations. These impaired chronic wounds usually promote a microbial biofilm, commonly characterized by the presence of multidrug-resistant microorganisms, hampering the efficacy of conventional antibiotic treatments. Honey has been shown to be an effective antibacterial component, including against multidrug-resistant bacteria. Honey’s physical–chemical characteristics, such as the presence of hydrogen peroxide, its low pH levels, and its high sugar and phenolic contents, promote anti-inflammatory and antioxidative activities, improving wound healing. This review aims to explore honey’s effects in wound healing, especially for DFUs, and to show how the different physical–chemical features among different honey types might influence the treatment’s effectiveness. For this, the mechanisms by which honey can promote wound healing and the potential use of honey dressings in diabetic wounds were investigated in animal models and humans. After revising the diabetic wound impairment mechanisms, we found that most of the clinical studies that treated DFUs with honey in animal models or humans reported accelerated wound healing, greater wound contraction, and lower amputation or hospitalization rates; however, few studies characterized the features of honeys used for wound treatment, hindering the possibility of extensively comparing the different types of honey and identifying characteristics that most successfully promote wound healing. According to this review, honey is a cost-effective and safe option for DFU management.
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spelling doaj.art-2a53916fb263480cac68d850194f0fe62023-12-08T15:11:49ZengMDPI AGApplied Sciences2076-34172023-11-0113231282010.3390/app132312820Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound HealingAndrea Bezerra0Hélder Fonseca1Francisca Rodrigues2Cristina Delerue-Matos3Irene Gouvinhas4Juliana Garcia5CITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Inov4Agro-Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, PortugalResearch Center in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, 4200-450 Porto, PortugalREQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 431, 4249-015 Porto, PortugalREQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida, 431, 4249-015 Porto, PortugalCITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Inov4Agro-Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, PortugalCITAB—Centre for the Research and Technology of Agro-Environment and Biological Sciences, Inov4Agro-Institute for Innovation, Capacity Building and Sustainability of Agri-Food Production, University of Trás-os-Montes e Alto Douro, 5001-801 Vila Real, PortugalDiabetic foot ulcers (DFUs) are considered a major problem for public health, leading to high rates of lower-limb amputations. Moreover, due to the high prevalence rate of predisposing factors, the incidence rate of DFU is still rising. Although DFUs are complex in nature, foot ulceration usually precedes diabetic foot amputations. These impaired chronic wounds usually promote a microbial biofilm, commonly characterized by the presence of multidrug-resistant microorganisms, hampering the efficacy of conventional antibiotic treatments. Honey has been shown to be an effective antibacterial component, including against multidrug-resistant bacteria. Honey’s physical–chemical characteristics, such as the presence of hydrogen peroxide, its low pH levels, and its high sugar and phenolic contents, promote anti-inflammatory and antioxidative activities, improving wound healing. This review aims to explore honey’s effects in wound healing, especially for DFUs, and to show how the different physical–chemical features among different honey types might influence the treatment’s effectiveness. For this, the mechanisms by which honey can promote wound healing and the potential use of honey dressings in diabetic wounds were investigated in animal models and humans. After revising the diabetic wound impairment mechanisms, we found that most of the clinical studies that treated DFUs with honey in animal models or humans reported accelerated wound healing, greater wound contraction, and lower amputation or hospitalization rates; however, few studies characterized the features of honeys used for wound treatment, hindering the possibility of extensively comparing the different types of honey and identifying characteristics that most successfully promote wound healing. According to this review, honey is a cost-effective and safe option for DFU management.https://www.mdpi.com/2076-3417/13/23/12820honeydiabetic foot ulcerdiabetic woundswound dressing
spellingShingle Andrea Bezerra
Hélder Fonseca
Francisca Rodrigues
Cristina Delerue-Matos
Irene Gouvinhas
Juliana Garcia
Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing
Applied Sciences
honey
diabetic foot ulcer
diabetic wounds
wound dressing
title Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing
title_full Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing
title_fullStr Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing
title_full_unstemmed Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing
title_short Honey Therapy in Diabetic Foot Ulcers: A Promising Strategy for Effective Wound Healing
title_sort honey therapy in diabetic foot ulcers a promising strategy for effective wound healing
topic honey
diabetic foot ulcer
diabetic wounds
wound dressing
url https://www.mdpi.com/2076-3417/13/23/12820
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AT franciscarodrigues honeytherapyindiabeticfootulcersapromisingstrategyforeffectivewoundhealing
AT cristinadeleruematos honeytherapyindiabeticfootulcersapromisingstrategyforeffectivewoundhealing
AT irenegouvinhas honeytherapyindiabeticfootulcersapromisingstrategyforeffectivewoundhealing
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