A sweet way to treat wounds

When Cody started licking at a small lesion on his paw, the owner’s grandchildren knew that licking a wound delays healing, so they covered the area with a plastic bag.  The puzzled owner of the Sheltie was now in our exam room, concerned because she had just noticed some sticky matted fur just above Cody’s ankle.  After thoroughly clipping and cleaning the wound, I found that it was at least ½-inch deep and extended around almost the entire circumference of Cody’s leg.  It was typical of a wound caused by a rubber band, and indeed the owner realized that her grandchildren had used a hair elastic to secure the plastic bag. 

Because the linear cut was so deep and contained dead tissue and pus, I chose to use a wound management technique that has been around since the 1600s:  sugar. 

There’s science behind the use of granulated sugar for this purpose, and it’s based on water.   Sugar absorbs moisture, and bacteria don’t like that; they require water to thrive.  So sugar in a wound inhibits bacterial growth.   Sugar also decreases tissue inflammation, attracts disease-fighting white blood cells, helps slough devitalized tissue while nourishing the healthy tissue,  and forms a protective layer of protein on the wound that  promotes healing.  None of the antibacterial ointments we use on wounds can claim all those benefits, nor are they as inexpensive as sugar. 

After the lesion is thoroughly cleaned, copious amounts of sugar are poured on the wound, which is then wrapped with a sterile absorbent dressing.  As the sugar draws moisture from the tissue, it eventually becomes diluted and less effective.  A bandage change must be done whenever strike-through has occurred, which is when moisture seeps to the outer layer of the dressing.  That might necessitate changing the bandage at least twice a day.   

Because of that, and because sugar bandages are messy to apply, many veterinarians prefer another sweet treatment:  honey. 

Unpasteurized honey has been a staple in wound cleansing and healing in humans for 4,000 years.  The active enzymes in honey contribute to its effectiveness but are destroyed by heating, so raw honey does best.  In addition to working like sugar, honey contains an antibacterial factor called inhibine, which is actually hydrogen peroxide (H2O2).  You might have heard that hydrogen peroxide can damage healthy tissue cells; that’s true, but the level of H2O2 produced by honey in one hour is 1,000 times less concentrated than the 3% stuff you have in your medicine cabinet.   That tiny amount of peroxide is antibacterial and is continuously generated by the honey.  It also stimulates the growth of blood vessels and healing tissue.  Best of all, there is no reported microbial resistance to honey; even multi-drug-resistant bugs succumb. 

One way to apply honey is to soak an absorbent dressing with it after cleaning the wound.  Medical-grade honey, which is free of contaminants such as pesticides, is best.  Commercial honey dressings also are available.  Honey dressings wick away moisture and adhere to the wound, which makes them excellent for debriding dead tissue from that area.  The bandages are changed once or twice a day, depending on how much strike-through occurs. 

Both honey and sugar bandages are used for a couple of days to a couple of weeks.   The end point is when a healthy pink bed of new tissue has formed.

My client’s Sheltie did really well with his sugar dressing:  By the next day, the wound was clean and the tissue a nice rosy color. 

Antibiotics are an important part of our armamentarium when we fight infection.  But it’s pretty cool that I could use something simple on Cody’s wound that was even better than antibiotics and – more important – didn’t contribute to the creation of the antibiotic resistance that is ubiquitous today.