By Ian Nielsen
I am sure many of you like me, have heard claims of honey being a good wound treatment. I decided to test this claim in my practice. Over the last few years I have been treating severe lower leg wounds with standard clear or raw honey, Manuka honey, with or without pretreatment with 3% hydrogen peroxide, and with occasional surgical removal of excess proud flesh or the judicial treatment with a cortisone cream.
I also tried to find a way to bandage these wounds that may be less expensive and that mostly still stay up! I restricted movement while the legs were bandaged. When wound contraction commenced and the wound seemed to be holding itself together I removed the bandage and allowed the wound to crust over and began to allow a gradual return to normal limb movement.
Typical cases
The wounds that have been treated have been on all legs and have included heel bulb splits, open joint wounds, complete cannon strips (the so called deglove wounds) and deep lacerations over the knee and forearm and the hock and lower thigh.
As most of you know the horse can self inflict wounds that look and are horrendous. They can be complicated by partial or complete cutting of tendons, ligaments and muscles. They can expose the bone and even rub a deep gouge into the surface of that bone.
Comment about the results
Firstly I must admit that these trials are not scientific studies. To be so, I should have treated every second wound with no honey and simply cleaned and changed bandages. Then I would have had a “control” group with which to compare the healing rates and the size of the scars at the end.
These cases were field trials and owners would not have appreciated that their horse had been selected as a control.
Therefore the results are based on my and my client’s experience with similar wounds treated in the many and various ways we have all used for eons. In scientific circles this is called anecdotal evidence and frowned upon.
Results of the trial
Honey is a very effective wound surface treatment. The time for full wound healing was in most cases almost halved.
There was no apparent difference between ordinary clear honey or Manuka or raw honey. Claims have been made for Manuka and raw (cloudy) honey and I have used it on some wounds with good effect but have also used it on alternate dressings with clear honey and not seen any difference. Some of my clients swear by raw honey and their experience with their own horses have made them firm believers in the benefit of raw honey over plain “off the shelf” clear honey.
3% hydrogen peroxide is claimed to improve the effect of the honey. One theory holds that the available oxygen released combines with nitrogen from the honey producing nitric oxide which improves blood flow to the wound. I have no idea whether this is true but when used as described later it did seem to improve the surface of the infilling tissue (the granulating tissue). Beware though, peroxide is damaging to delicate healing cells so should be used sparingly.
Bandaging and rest is paramount as wound movement is a killer to healing.
Honey in all its forms appears to be an effective antibacterial. The amount of pus and the odour on each bandage change is much less than any other wound treatment I have used.
The final scar is smaller and thinner than I would have predicted with all other forms of therapy, except of course skin grafting.
Vital to quick healing is to prevent the granulating tissue becoming so called “proud flesh” and overlapping the wound edges. As granulating tissue has no nerve endings the overlapping edge can be cut off without pain to the horse. This may be a good time to call the vet as s/he will be able to do this for you. You may be able to do it yourself next time. After having cut back proud flesh I will use Prednoderm or Panalogue to prevent fast regrowth. Both contain cortisone and are useful at this time and for one dressing change only.
Honey appears to protect the bone. I haven’t YET had a deep bone rub lead to localized death of the bone and a non healing wound. This has been a common occurrence in the past.
Wound management
I find I rarely suture wounds of the lower leg. Usually they are hard to clean; there is too much tension on the suture line when finished; and they have usually been exposed to the air for too long before I get to see them. They are then deeply infected. Stitching them closed simply prevents drainage.
I used to cut away flaps that were hanging, tidy up the wound as best as possible and then bandage them with whatever was my favourite at the time.
My advice now is if the wound is fresh, the owner quickly clean the wound and push everything back to as close as it was normally and apply any non stick dressing and a firm bandage over everything. When I arrive to examine the wreck at least the wound is clean and moist. I then decide what may be salvaged. What bits of tattered tendon or muscle that will simply continue to cause wound edge movement that will have to be removed. I will irrigate the wound with bag(s) of sterile intravenous fluids. I will clean under skin flaps but at this time, will not remove any skin – even though it is hard to imagine that all the skin will remain alive. I will push all the skin flaps to as close to their normal position and then the bandage is applied.
Bandaging the leg
The wound dressing is made from disposable baby’s nappies. The wings and top and bottom are cut off and then the remainder is cut to a size larger than the wound. Honey is poured onto the nappy (skin side of course) and pressed firmly onto the wound. A roll of cotton wool is used as padding and usually wrapped from below the wound to above. Commonly a third to a half a roll is used. A 4 inch heavy (washable) crepe bandage holds everything in place and is secured by one or two elastoplasts. Using a pair of cheap disposable gloves Crib Stop paste is then applied to the elastoplast surface. This is essential as the horse will chew the bandage off in no time especially with the honey underneath. Make sure no Crib Stop gets onto the horse’s leg.
I change the bandage every 3 to 4 days. I do not wash the wound but “dry clean” with freshly washed clean dry towels until all the old dressing, tissue, serum, blood and pus are removed. Wetting the wound between changes simply adds to the muck next time. With dirty wounds and especially with the early dressings I will syringe onto the wound 3% hydrogen peroxide. This will fizz and run down the leg but a white surface of bubbles will adhere to the open wound. I carefully clean away all the peroxide except for that remaining on the wound surface. I then replace the honey bandage as described. Once the wound is clean and healing, I rarely use the peroxide.
To prevent the bandage slipping or being pulled down by the horse use plenty of Crib Stop paste AND with high cannon wounds, always take the bandage above the knee or hock.
The cost of material used, is a roll of cotton wool per week, a jar of honey, 4 heavy crepes (1 on the horse, 1 soaking, 1 being washed and 1 drying), a jar of Crib Stop paste, a box of disposable nappies, a small bottle of 3% hydrogen peroxide and however many elastoplasts and of course, your time. You will need a partner/friend.
Managing the horse
The horse is kept in a stable until the wound is holding together firmly. If the skin flap is dying back or not grafting to the granulating tissue then it maybe time to trim it back. This decision usually is made for you by about the 2nd or 3rd week.
In the first week, bandage changing can be difficult as the wound is still painful. Be very gentle but firm, or arrange with your vet to do these changes with the horse sedated.
After about the 3rd change s/he will usually accept a bandage change no matter how large the wound. Of course there are exceptions to every rule!
When the wound has contracted to at least a third of its original size and the edges are closing in and no proud flesh is developing over the wound edge; when you can move both sides of the wound in opposite directions at the same time and there is no fear of it splitting open, then bandaging can stop and the horse allowed out of the box. The wound will crust over. Cream like a vitamin E cream can be applied to encourage less crust and scarring.
As a postscript:
As part of this clinical trial we took on two Thoroughbred yearlings who had demolished 5 out of 8 legs in a huge hail storm. The owner rightly requested that I euthanase both. Instead, and with his permission, we took over both horses and treated their legs with the above regime. It was not easy. They were yearlings and resented treatment. Nonetheless, with the aid of heavy sedatives, we treated these two and are pleased to report that they have both since won races. Mind you they still owe us a fortune but it was a great experience and part of a great learning curve.
The horse was anaesthetised in the above photo hence the legs are on the ground. You will see that the extensor tendon has been cut through on the bottom leg and appears as a tag sticking out from the top of the wound. The right (upper leg) has been injured to the bone and the white area in the centre of the wound is quite deep gouged bone.
The second photo. You can see the right leg has healed over the bone and has contracted quite well. This was at about 5 weeks after the injury. The left hind leg is the bandage before removal after 4 days. It is still snug and preventing wound movement. The discoloration is the cribstop paste that has been applied to the outside of the elastoplast to prevent the horse from chewing at his bandage. However he did manage to pull at the bottom of the nappy which you can see emerging from the bottom of the wound. Time to final healing when the leg was no longer bandaged was 8 weeks.
The day I went to take pictures of his healed wounds he had managed to give himself a new injury to the bottom of the right hind leg wound. Yes, he is “one of those”.
Thank you for writing up your findings. I will print this off and give to my vet.
i read about using honey for wounds while sitting in a vet,s office. I was akways impressed with his thinking out if the box. He likes to learn.
i think your experience and knowledge make your report of ypur findings valid. But then i am a horse iwner and not a scientist .
Thank you for this excellent report
I am 65 years old and have used honey and aloevera as wound treatment for 50 years; and I use collodial silver which was the precurser to penicillan. Many of the old practices work and they are simple and cheaper and the drug companies don’t own them!
I have a wonderful vet and trus himt; He works with me and I also have kept records of treatments and seen the different results. I will cold hose a wound then wash it with CS and then put a mixture of honey and 2% iodine on the wound. This is how I have had wounds heal faster; cleaner and usually no proud flesh.
My yearling had a bad infection in her hoof, which had travelled up her leg. The vet tried to get it to drain with no luck. He told me the skin would eventually split above the hoof to allow drainage. I did some research and used regular sugar and iodine in a baby diaper and duck tape to hold it. The swelling went down in about 3 days and the hoof healed incredibly well. I am going to try the same thing on a mean looking slice she now has on her ankle.
We have been trying since Feb 15 to heal a cut on the back of front leg…didn’t cut tendon, but due to tendon movement, cut will not heal. Given up bandages as seems to act as friction with tendon, wound in the middle rubs so much.,now all we have is clean edges and scab in the middle…skin will not grow across…tried everything…about 50 cent coin. Any ideas how to get skin moving? Wound area is kept flat and free of proud flesh.
Last summer (2014) one of our horses got a 10 inch gash on her barrel, about where your leg rests. We used a honey, sugar mixture on it and the wound healed beautifully. Not a place we could have ever bandaged. We applied the mixture several times a day as it would run off from her body heat. The honey was from our own bees, the only concern I had was our bees deciding to “rob” the honey off the horse but that was not an issue. Also several times a day I cleaned all the honey/sugar/pus mixture that had run down under her barrel and front leg but she seemed to enjoy that attention. Today there is about a 3 inch scar-not bad considering the initial injury.
My question to the Dr. is this…do you think honey treatment would work for a fungal infection on fetlock Pythiosis or Swamp Cancer? This has been treated by other methods for over 4 months, when rainy weather is at hand it looks worse, when dryer conditions it tends to shrink and crust over.
You obviously don’t understand the process by which honeybees are kept conventionally verse all natural methods and practices. Take a peek behind the curtain to understand what is and isn’t in a bear bottle dressed in honey. Go to
TrueSourceHoney.com
Just because it looks and taste like honey..does not mean its Honey from live plant nectar.
I would never eat nor treat horse wounds with honey I can’t source its beekeepers methods & practices to be chemical & antibiotic treatment free.
According to research from New Zealand (New Zealand’s Waikato Honey Research Unit), chemicals in the wound exudate combine with chemicals in the honey to form H2O2 which disinfects the wound. The difference in that hydrogen peroxide and what you pour on out of a bottle is that it doesn’t seem to damage healthy tissue. I’ve used honey to heal an 8″ long gash just above a horses gaskin that was all the way to the muscle. The wound healed with just honey. It healed quickly and from the inside out. It was a beautiful thing to watch.
In early April my horse degloved her right front leg it is horrible ingury that is having trouble healing due to the constant flexion of the knee. I just bought a jar of Manuka honey healing cream to apply to the wound as I am now at my wits end. I will make first application tonight 9/22/2015 and I will keep this website updated
Very interesting hearing about the honey. I have a filly who has cut to the bone on the front of her canon just below the hock and have treated her with honey and a firm bandage not unlike the way Ian Neilsen mentioned in his article. We have tried all sorts of treatments and this is the best. It is now almost totally healed (its taken nearly 4 months to heal this time) but the really worrying thing about this injury is that it is the fourth time it has happened to the filly (she is just 2 years old). Each time we get her right then put her back into work. She re-injures herself in the paddock and we can never find how she does it. Does anyone have any suggestions for protecting the wound while she’s in the paddock as we don’t like to stable our horses? Is there a product like an open mesh that would allow the leg to breath while at the same time protecting the old injury for say another year. How long before scar tissue is really strong? She’s a cutting horse.
I am very interested in this article. I have a horse that have a wound fo almost 4 months now around the knee. She has been put on antibiotics and wound have been dressed and bandage. Clean done on iodine and several other thinsgs. I think she has got proud flesh now. Can I still try te honey treatment? I do not know how to cut the proud flesh. Last week we saw magots and a vet suggested tepentine as we do not have anything else to use. Now the horse have stopped rubbing it’s leg but I think there is some abscess that need to be cleaned. Can I try the honey treatment?
My mare sliced the hide on her nose. It’s like she peeled it right now her nose. When I was at the local feed store I saw an older gentleman, in cow boy get up, so, I asked him if he had horses. He said yes, so I asked him if he had used any of the ointments I had been looking at and he kind of made a face then told me to put it back and to go across the street and buy some honey. He said Honey has saved his horses from being euthanized on numerous occasions. He said ” Honey and duct tape. ” lol I got a tub of organic raw clover honey , some gauze , self adhesive bandage and also duct tape to help reinforce the end to keep it In place if she decides to rub. Today is day one, hour one. I’m feeling very optimistic. He said once a day clean it with a bit of peroxide but not a lot because it produces proud flesh then just goop that honey on there..and goop it I did!! I placed her bandage around her like a halter. I just hope her stubborn butt keeps it on and doesn’t rub it off. Lol.
have just experienced a friends horse having lower leg wounds from being caught up in wire fencing I have a veterinary background working as a R.A.N A in England and I have never been a fan of bandaging …. its just not natural to the equine world and often causes more problems than it resolves I personally feel that we interfere too much and that less is more, clean the wound with sterile water if bandaging is necessary make sure that its secure which is hard when dressing lower leg wounds it needs to have pressure to prevent proud flesh, cheap form of bandaging is sanitary pads or nappies. I find every wound needs different treatment but once bandaging is over MANUKA HONEY IS THE BEST it keeps the wound clean repels flies so stops infection and dirt and heals the fastest. we also used coloidial silver and tuff rock to assist with the swelling.Another little tip is the pressure stockings they use in hospitals and on long plane flights great for protecting bandages and because the are elastic they apply the necessary pressure to reduce proud flesh the stockings can be cut to size
We have used honey (both Manuka and off the supermarket shelf type) for many years with great success. A little over a year ago it was suggested that Cinnamon sprinkled over the honey before applying to the wound would help and we have since been doing this. It appears to heal the wound even quicker and keeps the skin clean and healthy (honey and cinnamon ingested by people can also help with their health). On one mare that took the flesh on a hind leg back to bone, we could see the tendon shaft sitting in the open un-damaged. It took 3 weeks to totally heal to the point of the wound looking like we had just shaved the hair of the area. The skin was perfect. One important thing is to NOT change the bandage too often (we do every 3rd day). This gives it time to heal without being disturbed every day toy can also see great improvement every time the bandage is changed.
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It sure is great to see that we have alternates to fix things that sometimes modern med. can’t do or is very expensive to do. Great report . I enjoyed reading it & also reading some of the things others have done. Thanks for all your opinions.
I am at my wits end with my made who Degloved her near side hind. As it was fresh we sutured and compression bandaged. The sutures ruptured on day two and exposed bone however we persisted and from day one used manuka honey. I was pleased with the healing process with minimal proud flesh occurring and keeping her confined. Devastation and disappointment occurred when she bit it taking it back to bone. This has occurred four times with her doing it again yesterday though not quite to the bone this time. The lateral and posterior areas of the wound are healing beautifully as she has not yet accessed those areas. The honey is working a treat. It’s been two and a half months now and quite smelly. I dress every 2nd to third day to beat her chewing it and debride any necrotic matter……have even put a motocross knee and shin guard upside down to protect the wound and thanks to duct tape lasts two days before she is at it again. It does concern me that the chewing may be from necrosis and though smelly skin is still in tact…..there is no unusual amount of pus so am just persevering with application of honey. It’s a long haul and at times despairing when she causes a set back. Keeping hopeful and do recommend the use of honey.
Thank you for sharing your experiences in treating wounds with honey! It was a great help in writing my article about Manuka honey for horses.
interestingly enough I had a mare that got trapped under an electric fence and burned herself from the inside of the hock to the vulva…I was lucky enough to connect with a professor who had invented a metal infused pad for burn bandages in humans and he gave me some to use on this horse. It worked wonders although the area was next to impossible to keep bandaged due to the stifle movement and the large area involved. Later I had another vet recommend honey, and the professor was adamantly against it. Personally i think he was a bit blinded by his own technology. Honey does seem to work…and even as recently as earlier this year I did an “experiment” on myself..I had badly cracked heels due to going barefoot in Florida…and used a manuka honey pad on one heel and a “normal” antibiotic infused pad on the other….it was totally amazing to me but the honey not only soothed the area almost immediately (the other felt good to be covered but not soothed) and the honey bandage healed my foot in about 2 days whereas the other went on for over a week at which point I switched to honey!!!!
Hi.. am lucky to have a friendly naybour brekeeper!
He explained to me manuka honey is reputably the best… one reason is it is processed less due to its moisture content… 33%. So he cures all his honey at this moisture level.. some is wildflower mix.. all given me 100% success. . Sorry I cant give more details but thats what he said. And if bandaging or not… if eiynd stagnates or doesnt progress as expected after 3weeks a change to a dry powder or iodine starts it off on right path
This is quite interesting. I, myself love Manuka honey, but I’ve only used it to treat my IBS (Irritable Bowel Syndrome). I’ve read here and there that it can be applied directly to wounds and burns, but your post really covers it.
I’ve seen some bandages that contain small amount of Manuka honey, I wonder if they would be any good for small cuts. The ones you get while chopping salad in the kitchen.
Either way, this was quite the interesting read. Thank you.
I had two diabetic foot ulcers that would not heal for TWO YEARS despite using a variety of treatments. I enounteted the use of Menuka honey in an article while looking for treatment alternatives. A mere two weeks after beginning the use of Menuka, the wounds were completely healed. I was/am amazed.
Very interesting. I have a mare who gave birth to twins. Of course one was weaker and smaller than the other but is doing great now except for one of his legs. It was crooked, we put pvc pipes with lots of foam for 3 weeks to straighten it. It worked but gave him blisters on the inside of his leg. He has a wound 3 inches long and 2 inches wide on the side of his knee. We see his bone. I am trying the honey with cinnamon and collodial silver. Was wondering about the 3 to 4 days with the same bandage. Doesn’t the wound need air to dry it out a bit? And for Mary-Ellen Laidlaw, How do you use the iodine with the mixture? Thanks for the info!!!
Hello,
This information is great. Unfortunately my horse was not bandaged for long enough and the swelling has not gone down completely.
I am using honey right now, the wound has closed over and not scabby but still big.
Any suggestions?
Thank you.
A big THANK YOU!
I am a small animal vet in Canada. I have been working on my fjord’ s leg wound for 3 weeks, with iodine, flamazine cream and honey. I am so glad to see this in print, as I will persevere with more honey. It is healing well, but cannot be sutured. I can confirm I use the honey successfully in small animal practice all the time, especially for severe, degloving, “road rash” injuries in both dogs and cats. Keep up the great work! Ann
Hi! Alll the way from Bolivia. My filly 5 months old had a terrible case of summer sore that left open sore the size of a tennis ball. Grosome to the sight. I read tje article and applied it. I can see pink skin regenerating around the outside..its incredible! In the inner circle there is this red jello type material each time less and harder. I mixed honey and savila ginded and poured it in the dipper and bandaged it.
I can add 2 things to the article. 1. horses like the honey and will suck on it all night and chew it off…the fermentes saliva smells like roted carrotes. With the pepper it delays the chewing…in the day in the pasutre they wont chew at all..its in the night time. 2. Dont panic when you see all that red material. Dont hose it down as it can be an impulse to do so. As the article said wash around it.
Finally i cant thank enough this article. It is well written EASY to understand..not like those vet articles that make you whant to cry for not understandinv all those tecnical terms. Gracias mil
if you are wanting to have air circulating around a bad wound buy soft screening material ( nylon ) like you would use on a tent – you can tape around the top and bottom and leave it puffy where the wound is – take it off when needed to treat the wound – it can be washed to remove any crusty collection that may stick to the mesh – it works great at a minimal cost and can be used many times after being disinfected