Honey and venous leg ulceration: a systematic review & randomised controlled trial

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dc.contributor.advisor Professor Anthony Rodgers en
dc.contributor.advisor Dr Natalie Walker en
dc.contributor.author Jull, Andrew en
dc.date.accessioned 2008-10-30T04:07:05Z en
dc.date.available 2008-10-30T04:07:05Z en
dc.date.issued 2007 en
dc.identifier.citation Thesis (PhD--Clinical Trials Research Unit)--University of Auckland, 2007. en
dc.identifier.uri http://hdl.handle.net/2292/3132 en
dc.description.abstract Aims: To investigate the effect of honey on wound healing by conducting [1] a systematic review of trials of honey in wound care and [2] a randomised controlled trial of honey-impregnated dressings for the treatment of venous leg ulcers (the HALT trial). Systematic review: Method - The Cochrane Controlled Trials Register, AMED and LILACS were searched for controlled trials using honey for any type of patient with an acute or chronic wound. Honey manufacturers and researchers were contacted, citations scrutinised and the internet searched. Data from included studies were combined where studies were sufficiently alike. Findings - 18 trials were included. Honey significantly decreased healing time compared to conventional dressings for partial thickness burns (WMD -4.7 days, 95%Cl -5.1 to -4.3), but delayed healing time in comparison to early excision and skin grafting for mixed partial and deep thickness burns (WMD 25 days, 95%Cl 17.4 to 32.6). No significant effect was found for minor acute wounds or for honey compared to silver sulfadiazine in partial thickness burns. There were no trials of honey for treating venous leg ulcers. Randomised controlled trial: Method - The HALT trial was a pragmatic, open label randomised trial. Participants received either a manuka honey-impregnated calcium alginate dressing (n=187) or usual care (n=181) for 12weeks. Both groups received compression bandaging. The primary outcome was the proportion of participants with healed ulcers at 12 weeks. Secondary outcomes were time to healing, change in ulcer area, incidence of infection, adverse events, health-related quality of life and cost-effectiveness. Findings -104 participants in the honey-treated (55.6%) group and 90 (49.7%) in the usual care group healed at 12 weeks (absolute increase 5.9%, 95%Cl -4.3% to 15.7%, p=0.3). Time to healing was not significantly different between the groups (mean difference -1.8 days, 95%Cl -7.7 to 4.1, p=0.5), nor was change in ulcer area (mean difference 0.9cm2, 95%Cl -1.4cm2 to 3.2cm2, p=0.4)incidence of infection (absolute decrease 5.0%, 95%Cl -3.1% to 13.1%, p=0.2), ulcer recurrence (absolute increase 5.2%, 95%Cl -0.4% to 10.7%, p=0.1), or quality of life. The average cost of community-based treatment per participant was higher in the honey-treated group (NZ$862 versus NZ$795). More adverse events were reported in the honey-treated group (RR 1.3, 95%Cl 1.1 to 1.6, p=0.01). More participants reported pain as an adverse event when treated with honey (RR 2.5, 95%Cl 1.5 to 4.2, p=0.0001). Interpretation: Systematic review - Honey may be an effective treatment for partial thickness burns in comparison to conventional dressings. Honey does not appear to benefit healing in other acute wounds and may delay healing in mixed and partial thickness burns compared to excision and grafting. The HALT trial - Honey-impregnated dressings did not have any significant positive effect on venous ulcer healing and were more expensive than usual care. Participants treated with honey experienced more pain than control participants. en
dc.format Scanned from print thesis en
dc.language.iso en en
dc.publisher ResearchSpace@Auckland en
dc.relation.ispartof PhD Thesis - University of Auckland en
dc.relation.isreferencedby UoA1766913 en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Honey and venous leg ulceration: a systematic review & randomised controlled trial en
dc.type Thesis en
thesis.degree.discipline Medicine en
thesis.degree.grantor The University of Auckland en
thesis.degree.level Doctoral en
thesis.degree.name PhD en
dc.subject.marsden Fields of Research::320000 Medical and Health Sciences en
dc.rights.holder Copyright: The author en
pubs.local.anzsrc 11 - Medical and Health Sciences en
pubs.org-id Faculty of Medical & Hlth Sci en

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