How to Apply Medihoney Wound/Burn Dressing External Gel
Apply Medihoney gel directly to the cleaned burn wound surface in a layer approximately 1/16 inch thick (similar to silver sulfadiazine application), then cover with a clean nonadherent secondary dressing to maintain moisture and protect from contamination. 1, 2
Pre-Application Preparation
Pain Control
- Establish adequate analgesia before wound care, as burn dressing changes can be extremely painful and may require deep sedation or general anesthesia for severe burns 3, 1
- Use titrated intravenous opioids and ketamine for severe burn pain, or consider inhaled nitrous oxide if IV access is unavailable 1, 2
Wound Cleaning
- Clean the burn wound thoroughly in a clean environment using tap water, isotonic saline solution, or an antiseptic solution to remove debris and foreign matter 3, 1, 2
- Perform thorough irrigation before applying any dressing 1, 2
- This cleaning step must occur only after proper resuscitation in severe burns—wound care is not a priority until the patient is stabilized 3, 1
Application Technique
Direct Application
- Apply the Medihoney gel directly to the cleaned wound bed in a thin layer approximately 1/16 inch thick, ensuring complete coverage of the entire wound surface 1, 2
- The gel should be applied once to twice daily, similar to silver sulfadiazine application protocols 2
Secondary Dressing
- Cover the honey-coated wound with a clean nonadherent dressing as the secondary layer to maintain moisture, reduce pain, protect from external contamination, and limit heat loss 1, 2
- When applying dressings to limbs, prevent bandages from creating a tourniquet effect by avoiding excessive tightness 3
- Monitor distal perfusion in circular dressings to ensure adequate blood flow 3
Evidence Supporting Medihoney Use
Antimicrobial Efficacy
- Medical-grade honey demonstrates potent antibacterial activity against typical wound pathogens including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci 4, 5
- In superficial burns, honey dressing rendered 91% of wounds sterile within 7 days compared to only 7% with silver sulfadiazine 6
- Medihoney-supplemented products (like L-Mesitran) show superior antimicrobial effects against Pseudomonas aeruginosa compared to Medihoney alone, suggesting synergistic benefits when honey is combined with other components 7
Healing Outcomes
- Honey-treated burns achieve 100% healing within 15 days compared to 50% with alternative dressings 8
- Healthy granulation tissue appears earlier with honey (mean 7.4 days) versus silver sulfadiazine (13.4 days) 6
- However, one recent study found that Medihoney treatment resulted in complete lack of re-epithelialization and keratinocyte proliferation in an ex vivo model, while supplemented honey products (L-Mesitran) performed better 7
Additional Benefits
- Honey provides superior pain relief compared to conventional dressings 6
- Lower incidence of hypertrophic scarring and post-burn contracture with honey treatment 6
- Moist dressings like honey significantly reduce complications including hypertrophic scarring (RR 0.13; 95% CI 0.03-0.52) 2
Dressing Change Schedule
- Re-evaluate dressings daily, ideally 3
- Reapply honey gel once to twice daily during dressing changes 2
Critical Caveats
When NOT to Use as First-Line
- Topical antibiotics (including honey) should be reserved for infected wounds only, not used as first-line prophylaxis on clean burns 3, 1, 2
- For large or contaminated burns, an antiseptic dressing may be more appropriate than honey 3
- Avoid prolonged use of any single agent on superficial burns, as even silver sulfadiazine delays healing when used long-term 3
Monitoring Requirements
- Monitor for signs of infection including increasing pain, redness, swelling, or purulent discharge 1, 2
- Burn wounds are initially sterile but rapidly colonize with Gram-positive bacteria, followed by Gram-negative organisms within a week 1