title: Randomised controlled feasibility trial on the use of medical grade honey following microvascular free tissue transfer to reduce the incidence of wound infection.
abstract: The aim of this study was to assess the feasibility of using Leptospermum honey in a randomised trial to reduce the incidence of wound infection after microvascular free tissue reconstruction for cancer of the head and neck. During the one-year study period 70 consecutive patients were admitted to the regional maxillofacial ward for free tissue reconstruction. Of these, 56 (80%) consented to be randomised and 49 (70%) were actually randomised, 25 into the honey dressings group, and 24 into the conventional dressings group (control). Six patients were missed when consent was required, 8 did not consent, and 7 who had given consent were missed at the randomisation stage in theatre. Results of wound swabs were positive in 36% of the honey group and 38% of the control group. Methicillin-resistant Staphylococcus aureus (MRSA) was found in 28% and 25%, respectively. Of these, 38% were deemed to require intervention. Honey dressings were acceptable to both patients and nurses. There was a reduction (p<0.05) in duration of hospital stay in the honey group (median 12 days, IQR 10-21) compared with the control (median 18 days, IQR 13-28). The cost of standard and honey dressings was similar. This feasibility study has shown that a randomised controlled trial (RCT) is possible and that several hundreds of patients would be required to show a clinical benefit for honey. Further research is needed to confirm a shorter duration of hospital admission and if so, whether this is due to more rapid healing.
authors.affiliation: CNS Leg Ulcer Care, Aintree University Hospital, Liverpool L9 7AL, United Kingdom. val.robson@aintree.nhs.uk
authors.forename: Val
authors.initials: V
authors.lastname: Robson
authors.forename: Janelle
authors.initials: J
authors.lastname: Yorke
authors.forename: Rachel A
authors.initials: RA
authors.lastname: Sen
authors.forename: Derek
authors.initials: D
authors.lastname: Lowe
authors.forename: Simon N
authors.initials: SN
authors.lastname: Rogers
mesh_terms: D000368:Aged; D001458:Bandages; D005240:Feasibility Studies; D005260:Female; D058752:Free Tissue Flaps / Q000098:blood supply*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006722:Honey; D006801:Humans; D059012:Lost to Follow-Up; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification; D017060:Patient Satisfaction; D018579:Patient Selection; D012107:Research Design; D018401:Sample Size; D018709:Statistics, Nonparametric; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires