ACCELERATION OF WOUND HEALING BY TOPICAL APPLICATION OF HONEY TO WOMEN WITH OBSTETRIC AND GYNECOLOGICAL
OPERATIONS
INTRODUCTION
Wound infection is defined as the presence of purulent discharge in or exuding from the wound or spreading erythema indicative of cellulitis around the wound. It results from microbial contamination during or after surgical procedure (Maclean, 2000).
Wound are breaks in the continuity of the soft parts of the body structure, surgical incised wounds are clean wounds with minimal tissue damage so, surgical site infections are a feared complication of any surgical procedure since surgical wound infections are a major cause of morbidity, prolonged hospital stay and increase in expensive. Infections of clean surgical wound are generally (Wilkinson, 1999).
The usage of honey as a medicine is referred to in the most ancient written records. Honey was prescribed by the physicians of many ancient races of people for a wide variety of aliments. The ancient usage of honey as a method accelerating wound healing has been described by Beck, Smedley, Majno and Forrest, the Ancient Egyptians, Assyrians, Chinese, Greeks and Romans, all used honey to treat wounds (Seymour, 2002). Honey inhibits the growth of several gram positive and gram negative bacteria as well as some fungi, also contains the enzyme catalose which adds to healing power. Rapidly cleaning up infected, purulent wounds with sloughs, necrotic and gangrenous tissue separating easily from the wound bed to leave a healthy surface with minimal scar (Green, 2001).
Honey as an adjuvant for acceleration of wound healing is widely accepted in falk medicine and the use of wound salves containing honey was mentioned in Egyptian papyrus dating from before 2000 BC (Greenwood, 1999). Topical application of honey for treatment of wound revealed that honey rendered wounds sterile and control infection if present within few days, healthy granulation tissue formation with relief of pain and acceleration of epithelialization in comparison with sulfadiazine gauze dressings (Subrahmanyan, 1999). According to Postmes (1999), wound healing properties of honey afford cleaning absorption of oedema, antimicrobial activity and promotion of granulation tissue formation and epithelialization.
The predisposing factors that represent multiple reasons for increase of postoperative wound infection, that already have been validated and documented as risk factors which might cause lengthened duration of hospital stay are diabetes mellitus, emergency operation, operations achieved by non trained surgeons and operating time as well (Karim, 2000). The most common organisms involved in post operative wound infection include staphylococcus aureus, streptococcus faecalis, escherichia coli (E. coli) klebsiella, pseudomonas, proteusbacteroidfragilis and anaerobic streptococci (Mashita, 2001).
The organisms that cause postoperative wound infection are either of exogenous and endogenous origin. The exogenous organisms are mostly transmitted to the patient from the environment or by contact with health team. The endogenous organisms causing wound infections are produced from the body of the patient and they may include bacteria acquired in hospital prior to surgery (Ako, 2000). Following injury that causes irreversible cell death and connective tissue disruption, an organized complex cascade of cellular and biochemical events result in a healed wound.(Silver, 2000).
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