Evaluation of Honey-Based Pharmaceutical Preparations for the Management of Diabetic Wounds

doi.org/10.26538/tjnpr/v6i1.18

Authors

  • Bisola O. Ojo Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, University of Lagos, Nigeria
  • Nkechi V. Enwuru Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, University of Lagos, Nigeria
  • Udoma E. Mendie Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmacy, University of Lagos, Nigeria

Keywords:

Aloe vera, Antimicrobial activity, Chlorhexidine, Diabetic wounds, Hone, Syrup

Abstract

Management of Diabetic wounds is a financial burden globally. Investigations into cheaper and alternative dressings to manage these wounds especially in developing countries like Nigeria is crucial. Honey was used to treat wounds since ancient times till nowadays. This present study  aimed at preparing honey with other actives and assay its antimicrobial properties and wound healing activity; in-vitro and in-vivo, also to compare its effectiveness against sugar syrup. Raw honey obtained was processed and characterized. Eight formulations F1 to F4 containing 66.7% syrup and either chlorhexidine or aloe-vera or both and F5 to F8 containing 75% Honey with or without the other actives were prepared, characterized, and investigated on their antimicrobial and wound healing properties in a diabetic rat model. The honey sample was found to be of good quality from the physicochemical and microscopical analysis carried out. Formulation F8 containing Honey 75%, Aloe vera 1%, and chlorhexidine 0.02% showed the highest antimicrobial activity with none of the formulations showing any significant activity against the fungal isolate. The wound healing effects of the formulations were comparative but honey containing formulations showed better diabetic wound healing activity with formulation F8 giving total and complete healing of the diabetic wound. Honey in conjunction with Aloe vera and chlorhexidine has better antibacterial and wound healing activity than syrup, according to this study, and could be utilized as a safe and effective natural diabetic wound healing treatment. 

References

Sen CK. Human Wound and Its Burden: Updated 2020 Compendium of Estimates. Adv Wound Care. 2021;10(5):281–92.

Rosyid FN. Etiology, pathophysiology, diagnosis and management of diabetics’ foot ulcer. International Journal of Research in Medical Sciences. 2017; 5(10):4206–4213.

Ugwu E, Adeleye O, Gezawa I, Okpe I, Enamino M, Ezeani I. Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicenter evaluation of diabetic foot ulcer in Nigeria. World J Diabet. 2019; 10(3):200–11.

Adeleye OO, Ugwu ET, Gezawa ID, Okpe I, Ezeani I, Enamino M. Predictors of intra-hospital mortality in patients with diabetic foot ulcers in Nigeria: Data from the MEDFUN study. BMC Endocrine Disorders. 2020;20(1):1-10.

Everett E and Mathioudakis N. Update on management of diabetic foot ulcers. Annals of the New York Acad Sci. 2018; 1411(1):153.

Negut I, Grumezescu V, Grumezescu AM. Treatment strategies for infected wounds. Mole. 2018; 23(9):1–23.

Oguntibeju OO. edicinal plants and their effects on diabetic wound healing [Internet]. Vet World. 2019; 12(5):653–63.

Cooper R. The use of honey in diabetic foot ulcers Article points. The Diabet Foot J. 2017; 20(3):154–9.

El-Kased RF, Amer RI, Attia D, Elmazar MM. Honeybased hydrogel: In vitro and comparative in vivo evaluation for burn wound healing. Scientific Reports. 2017; 7(1):1-11.

Surahio AR, Khan A, Farooq M, Fatima I. Role of honey in wound dressing in diabetic foot ulcer. J Ayuv Med Col, Abbottabad. 2013; 26(3):304–6.

Hekmatpou D, Mehrabi F, Rahzani K, Aminiyan A. The effect of aloe vera clinical trials on prevention and healing of skin wound: A systematic review. Iran J Med Sci. 2019; 44(1):1–9.

Pereira S, Moura J, Carvalho E, Empadinhas N. Microbiota of Chronic Diabetic Wounds: Ecology, Impact, and Potential for Innovative Treatment Strategies. Frontiers in Microbiol. 2017; 8(1791):1–12.

Sari Y, Purnawan I, Kurniawan DW, Sutrisna E. A Comparative Study of the Effects of Nigella sativa Oil Gel and Aloe Vera Gel on Wound Healing in Diabetic Rats. J Evid-Based Integrat Med. 2018; 23:2515690X1877280.

Edmiston CE, Bruden B, Rucinski MC, Henen C, Graham MB, Lewis BL. Reducing the risk of surgical site infections: Does chlorhexidine gluconate provide a risk reduction benefit? American J Infect Control. 2013; 41(5):S49–55.

Edmiston CE, Spencer M, Leaper D. Antiseptic Irrigation as an Effective Interventional Strategy for Reducing the Risk of Surgical Site Infections. Surgical Infect. 2018; 19(8):774–80.

Frisch NB, Kadri OM, Tenbrunsel T, Abdul-Hak A, Qatu M, Davis JJ. Intraoperative chlorhexidine irrigation to prevent infection in total hip and knee arthroplasty. Arthroplasty today. 2017; 3(4):294–7.

Pavlík V, Sojka M, Mazúrová M, Velebný V. Dual role of iodine, silver, chlorhexidine and octenidine as antimicrobial and antiprotease agents. PLoS ONE. 2019; 14(1): e0211055

Wyganowska-Swiatkowska M, Kotwicka M, Urbaniak P, Nowak A, Skrzypczak-Jankun E, Jankun J. Clinical implications of the growth-suppressive effects of chlorhexidine at low and high concentrations on human gingival fibroblasts and changes in morphology. Internat J Mole Med. 2016; 37(6):1594–600.

Subramanian R, Umesh Hebbar H, Rastogi NK. Processing of Honey: A Review. International J Food Properties. 2007; 10(1):127–43.

Azonwade FE, Paraïso A, Agbangnan Dossa CP, Dougnon VT, N’Tcha C, Mousse W, et al. Physicochemical Characteristics and Microbiological Quality of Honey Produced in Benin. J Food Quality. 2018; 201:1-13

Microbiological Examination of Non Sterile Products: Microbial Enumeration tests. In: The United States Pharmacopeia National Formulary. Rockville (MD): US Pharmacopoeial convention; 2017.

Chen MX, Alexander KS, Baki G. Formulation and Evaluation of Antibacterial Creams and Gels Containing Metal Ions for Topical Application. J Pharmaceut. 2016; 2016:5754349.

Viswanad V, Aleykutty NA, Jayakar B, Zacharia SM, Thomas L. Development and evaluation of antimicrobial herbal formulations containing the methanolic extract ofSamadera indica for skin diseases. Journal of advanced pharmaceutical technology & research. 2012; 3(2):106–11.

Frykberg RG and Banks J. Challenges in the Treatment of Chronic Wounds. Advances in wound care. 2015; 4(9):560– 582.

Anthony CRM and Balasuriya DN. Electronic Honey Quality Analyser. Engineer: Journal of the Institution of Engineers, Sri Lanka. 2016; 49(3):41.

Codex Committee on Sugars, Revised Codex Standard for Honey. Joint FAO/WHO Food Standard Programme Codex Alimentarius Commission. Twenty-fourth Session. London, United Kingdom; 2001.

Akpo OE. Comparative Pollen analysis of Honeys from Apiary and open markets in Nigeria and Benin Republic. Ife J Sci. 2017; 19(2):217–225.

Ibrahim IF, Balasundram SK, Abdullah NAP, Alias MS, Mardan M. Morphological characterization of pollen collected by Apis Dorsata from a tropical rainforest. International Journal of Botany. 2012; 8(3):96-106.

Oyerinde A, Lawal A, Olowookere T. Palynological Analyses of Honeys Produced in Honey-flow Season in Oyo State, Nigeria. Internat J Agric Earth Sci. 2017; 3(3):1-6.

Ahmed M, Khiati B, Meslem A, Aissat S, Djebli N. Evaluation of Physicochemical and Antioxidant Properties of Raw Honey from Algeria. J Microbial & Biochem Technol. 2014; S4(006):1-6.

Naila A, Flint SH, Sulaiman AZ, Ajit A, Weeds Z. Classical and novel approaches to the analysis of honey and detection of adulterants. Food Control. 2018; 90:152–65.

Buba F, Gidado A, Shugaba A. Analysis of Biochemical Composition of Honey Samples from North-East Nigeria. Biochem & Analyt Biochem. 2013; 2(3):139

Jones EM, Cochrane CA, Percival SL. The Effect of pH on the Extracellular Matrix and Biofilms. Adv wound care. 2015; 4(7):431–439.

Wasihun AG and Kasa BG. Evaluation of antibacterial activity of honey against multidrug resistant bacteria in Ayder Referral and Teaching Hospital, Northern Ethiopia. SpringerPlus. 2016; 5(1):842.

Almasaudi SB, Al-Nahari AAM, Abd El-Ghany ESM, Barbour E, Al-Muhayawi SM, Al-Jaouni S, Azhar E, QariM, Qari YA, Harakeh S. Antimicrobial effect of different types of honey on Staphylococcus aureus. Saudi J Biol Sci. 2017; 24(6):1255–1261.

Mama M, Teshome T, Detamo J. Antibacterial Activity of Honey against Methicillin-Resistant Staphylococcus aureus: A Laboratory-Based Experimental Study. Internat J Microbiol. 2019; 2019:1-9.

Omafuvbe BO and Akanbi OO. Microbiological and physico-chemical properties of some commercial Nigerian honey. Afri J Microbiol Res. 2009; 3(12):891–6.

De Silva V, Erathna S, Dissanayake D. In-vitro evaluation of antimicrobial effects of Sri Lankan bee honey against microorganisms causing chronic wounds - A preliminary study. Bulletin of the Sri-Lanka coll of Microbiol. 2017; 15(1):21–2.

Mphande AN, Killowe C, Phalira S, Jones HW, Harrison WJ. Effects of honey and sugar dressings on wound healing. J wound care. 2007; 16(7):317–9.

Kamaratos AV, Tzirogiannis KN, Iraklianou SA, Panoutsopoulos GI, Kanellos IE, Melidonis AI. Manuka honey-impregnated dressings in the treatment of neuropathic diabetic foot ulcers. Internat Wound J. 2014; 11(3):259-263.

Al Saeed M. Therapeutic Efficacy of Conventional Treatment Combined with Manuka Honey in the Treatment of Patients with Diabetic Foot Ulcers: A Randomized Controlled Study. The Egypt J Hospit Med. 2013; 53(1):1064-1071.

Imran M, Hussain MB, Baig M. A randomized, controlled clinical trial of honey-impregnated dressing for treating diabetic foot ulcer. J College of Phys and Surgeons Pakistan. 2015; 25(10):721-725.

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Published

2022-01-01

How to Cite

O. Ojo, B., V. Enwuru, N., & E. Mendie, U. (2022). Evaluation of Honey-Based Pharmaceutical Preparations for the Management of Diabetic Wounds: doi.org/10.26538/tjnpr/v6i1.18. Tropical Journal of Natural Product Research (TJNPR), 6(1), 109–116. Retrieved from https://tjnpr.org/index.php/home/article/view/202