Some clinicians are under the impression that there is little or no evidence to support the use of honey as a wound dressing. This impression is reinforced by it being concluded in systematic reviews that the evidence is not of a high standard. But likewise the evidence for modern wound dressing products is of not of a high standard. For evidence-based medicine to be practised in wound care, when deciding which product to use to dress a wound it is necessary to compare the evidence that does exist, rather than be influenced by advertising and other forms of sales promotion. To allow sound decisions to be made, this review has covered the various reports that have been Key words: evidence, honey, infected wounds, surgical wounds, burns, ulcers, abscesses, skin grafts, moist dressings, non-stick, debriding, deodorising, antibacterial, anti-inflammatory, prevention of scarring 3 There is a rapidly increasing interest in the use of honey as a wound dressing, but it is common to hear clinicians express the opinion that there is no evidence to support the use of honey as a wound dressing. However, the impression upon which this opinion is based is most likely to be a reflection of the scarcity of advertising and other commercial promotion of honey for wound care relative to that of other wound care products. Even where reviews of clinical evidence for the use of honey have been published, a negative impression is often obtained from consulting these, as the conclusions stated are that the evidence is of low quality and/or that there is a need for more evidence.1-6 But the myriad of advertisements for modern wound dressings possibly blinds people to the fact that only small, poor-quality trials exist to support the use of these products. The literature cited was found by searching the PubMed, BIOSIS and ISI Web of Science databases for the term "honey". Also, literature not included in the databases was found from citations in papers that were. Excluded were papers where honey was used in a mixture with other therapeutic substances, papers giving brief reports on the use of honey on cases where there was insufficient information on the cases given for the reader to judge if the positive outcomes were the result of honey being more effective than the prior treatment, and papers that were expressions of opinion rather than reports of treatment of wounds with honey. Conference presentations were also excluded.
CLINICAL EVIDENCE
4Many randomised controlled trials have been carried out comparing honey with various other wound treatments. These trials and the results obtained from them are summarised in Table 1. Other clinical trials have been conducted where the form of the trial has been other than a randomised controlled trial. In some of these the results for