title: The efficacy of topical Royal Jelly on diabetic foot ulcers healing: A case series.
abstract: BACKGROUND
  Foot ulcers and infections are the major sources of morbidity in individuals with diabetes mellitus. This study aimed to evaluate the efficacy of topical Royal Jelly (a worker honey bee product) on healing diabetic foot ulcers.
  
  
  METHODS
  Diabetic patients with foot ulcers that were referred to our clinic at Khorshid Hospital, Isfahan, Iran; were evaluated three times a week and treated according to standard treatments consisted of offloading, infection control, vascular improvement and debridement if required. In addition, all ulcers were measured and then topical sterile 5% Royal Jelly was applied on the total surface area of the wounds. Eventually, they were covered with sterile dressings. Each patient was followed for a period of three months or until the complete healing.
  
  
  RESULTS
  A total of eight patients were enrolled in this study. Of these, two had two ulcers and, therefore, ten ulcers were evaluated. Two ulcers were excluded. Seven of the remained eight ulcers healed. Mean duration of complete healing was 41 days. One ulcer did not completely heal but improved to 40% smaller in length, 32% in width and 28% in depth. The mean length, width and depth reduction rates were 0.35 mm/day, 0.28 mm/day and 0.11 mm/day, respectively.
  
  
  CONCLUSIONS
  Royal Jelly dressing may be an effective method for treating diabetic foot ulcers besides standard treatments.
authors.affiliation: Associate professor of endocrinology, Isfahan University of medical sciences, Isfahan, Iran.
authors.forename: Mansour
authors.initials: M
authors.lastname: Siavash
authors.forename: Saeideh
authors.initials: S
authors.lastname: Shokri
authors.forename: Sepehr
authors.initials: S
authors.lastname: Haghighi
authors.forename: Mahbubeh
authors.initials: M
authors.lastname: Mohammadi
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Shahtalebi
authors.forename: Ziba
authors.initials: Z
authors.lastname: Farajzadehgan