Medical grade honey reduces risk of surgical site infections after colic operations, researchers find

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An example of the application of medical-grade antimicrobial honey when closing up after colic surgery.

Medical grade honey gel shows promise in reducing the number of infections in surgical incisions arising from colic surgery.

Dr Kajsa Gustafsson and her colleagues at the Koret School of Veterinary Medicine, part of the Hebrew University of Jerusalem in Israel, reported their findings recently in the Equine Veterinary Journal.

Colic in horses may be due to an accumulation of gas, fluid, or feed, and can lead to obstruction of the bowel. Colic can become life-threatening in a short time.

Urgent and adequate veterinary care is important, with emergency abdominal surgery required in roughly 20% of cases.

Colic surgeries come with other risks, such as surgical site infections, which have a reported prevalence as high as 39%, and an average of 20%.

Therefore, alternative, or complementary therapies are urgently needed.

The study team noted that medical-grade honey has been used successfully to treat infections in both humans and animals.

Previously, a randomized controlled trial showed that the application of medical-grade honey gel, in the form of a commercially available antimicrobial honey product called L-Mesitran Soft,  in equine lacerations improved wound healing and significantly reduced infection rate.

The researchers noted that there were no similar studies evaluating the effects of medical-grade honey on incisions arising from abdominal surgery.

They set out to investigate whether L-Mesitran Soft would decrease the prevalence of incision-related infections in horses whounderwent colic surgery.

The study centered on 108 horses admitted to the Koret School of Veterinary Medicine that required colic surgery.

Horses were randomly assigned to either the control group or the treatment group.

In the treatment group, following closure of the linea alba (the abdominal midline), the honey-based gel was placed in the incision, followed by routine closure of subcutaneous tissue and skin.

Animals were subsequently excluded if they needed a second abdominal surgery (four horses) or did not survive for at least two weeks following the surgery (15 horses).

This resulted in the inclusion of 89 horses in total — 40 in the control group and 49 in the treatment group.

The incision and any post-operative complications were assessed at five time points: 24 hours, 48 hours, 5 days, 14 days and 3 months after surgery.

Gustafsson and her colleagues reported that a single application of the honey gel in the incision strongly reduced the incisional infection rate from 32.5% (13/40) in the control group to 8.2% (4/49) in the treatment group.

No adverse reactions were observed from the use of the gel.

The researchers described the application of the gel on the linea alba as a simple and rapid procedure that was safe.

Just the single application had significantly decreased the prevalence of incision-related infections in the study horses, they wrote.

The authors suggest more research is necessary to explore this promising approach beyond colic, such as surgeries known to carry a high risk of surgical site infections.

Intra‐incisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: a prospective randomised controlled study.
Kajsa Gustafsson, Amos J. Tatz, Roni A. Slavin, Gila A. Sutton, Roee Dahan, Wiessam Abu Ahmad, Gal Kelmer.
Equine Veterinary Journal, December 19, 2020 https://doi.org/10.1111/evj.13407

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