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Equine veterinary journal2021; 53(6); 1112-1118; doi: 10.1111/evj.13407

Intraincisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: A prospective randomised controlled study.

Abstract: Medical grade honey has previously been described as a prophylactic treatment for wounds. Local prophylactic treatment may be valuable in preventing post-operative incisional infections in horses undergoing colic surgery but has not been evaluated. Objective: To establish whether medical grade honey gel, applied on the linea alba intraoperatively, decreases the prevalence of incisional infections in horses undergoing colic surgery with no associated adverse effects. Methods: Prospective blinded randomised controlled clinical study. Methods: Horses older than 4 months that underwent colic surgery between May 2017 and December 2018 and survived for >2 weeks were included in the study. Horses were allocated 1:1 to treatment or control by block randomisation. In the treatment group, following closure of the linea alba, medical grade honey gel (L-Mesitran Soft® ) was placed in the incision followed by apposition of subcutaneous tissue and skin. Information regarding the incision and post-operative complications was obtained at five time points (24 hours, 48 hours, 5 days, 14 days and 3 months). Results: Eighty-nine horses were included in the study. No adverse effects associated with treatment were observed. Horses in the treatment group had a lower rate of incisional infection compared with the control group (8.2% vs. 32.5%, P = .02). The protective effect of MGH had a calculated adjusted odds ratio (OR) of 0.2 (95% CI:0.07-0.8, P = .03). The number of patients required to receive treatment to prevent one case of incisional infection (NNEB) was 4.7. Risk factors associated with infection included: younger age (OR = 27, 95% CI: 2.3 to 306, P = .008) and diarrhoea 48 hours post-operatively (OR = 20, 95% CI: 1.5 to 277, P = .02). Conclusions: Follow-up was performed by different veterinary surgeons, hence not completely uniform. Conclusions: Local prophylactic treatment with medical grade honey gel in the abdominal incision during surgery is safe and may significantly decrease the prevalence of incisional infections in horses undergoing colic surgery.
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Publication Date: 2021-01-15 PubMed ID: 33340154DOI: 10.1111/evj.13407Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article investigates the use of medical grade honey gel in reducing the prevalence of surgical wound infection in horses undergoing colic surgery. The study found that using honey gel significantly lowered the occurrence of incisional infections without causing any adverse effects.

Objective and Methodology

  • The research aimed to ascertain if medical grade honey gel, applied intraoperatively on the surgical wound (linea alba), could help lower instances of post-surgery infection in horses.
  • The study was a prospective randomized controlled clinical experiment carried out on horses older than four months who underwent colic surgery between May 2017 and December 2018 and survived for more than two weeks post-surgery.
  • Block randomization was implemented to distribute the horses evenly into a treatment group, in which medical grade honey gel was used, and a control group.
  • The condition of the incision and any post-operative complications were recorded at five different points: 24 hours, 48 hours, 5 days, 14 days, and 3 months after surgery.

Results and Conclusion

  • A total of 89 horses were considered for the study, with no negative side effects observed in relation to the treatment.
  • The results showed significantly lower rates of infection in the group treated with honey gel in comparison to the control group (8.2% as opposed to 32.5%, p=0.02), equating to a protective influence of the honey with an adjusted odds ratio of 0.2.
  • The study calculated that, to prevent one case of incisional infection, about 4.7 horses would need to receive the treatment.
  • Risk factors associated with increased infection chances included younger age and post-operative diarrhoea 48 hours after surgery.
  • The research concluded that using medical grade honey gel as a local preventive treatment during surgery was safe and could substantially minimize the prevalence of incisional infections in colic surgeries for horses.

Limitations

  • The researchers acknowledged one limitation in the study methodology: the follow-ups were not entirely consistent as they were conducted by different veterinary surgeons.

Cite This Article

APA
Gustafsson K, Tatz AJ, Slavin RA, Sutton GA, Dahan R, Ahmad WA, Kelmer G. (2021). Intraincisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: A prospective randomised controlled study. Equine Vet J, 53(6), 1112-1118. https://doi.org/10.1111/evj.13407

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 6
Pages: 1112-1118

Researcher Affiliations

Gustafsson, Kajsa
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot, Israel.
Tatz, Amos J
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot, Israel.
Slavin, Roni A
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot, Israel.
Sutton, Gila A
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot, Israel.
Dahan, Roee
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot, Israel.
Ahmad, Wiessam A
  • Hebrew University-Hadassah Braun School of Public Health and Community Medicine, Jerusalem, Israel.
Kelmer, Gal
  • Department of Large Animal Medicine and Surgery, Koret School of Veterinary Medicine, The Robert H. Smith Faculty of Agriculture, Food and Environment, the Hebrew University of Jerusalem, Rehovot, Israel.

MeSH Terms

  • Animals
  • Colic / surgery
  • Colic / veterinary
  • Honey
  • Horse Diseases / prevention & control
  • Horses
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Postoperative Complications / veterinary
  • Prevalence
  • Prospective Studies
  • Retrospective Studies

References

This article includes 26 references
  1. Mair T, Smith L. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival.. Equine Vet J 2005;37:310-4.
  2. Colbath A, Patipa L, Berghaus R, Parks A. The influence of suture pattern on the incidence of incisional drainage following exploratory laparotomy.. Equine Vet J 2013;46:156-60.
  3. Mair T, Smith L. Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 2: Short-term complications.. Equine Vet J 2005;37:303-9.
  4. Phillips T, Walmsley J. Retrospective analysis of the results of 151 exploratory laparotomies in horses with gastrointestinal disease.. Equine Vet J 1993;25:427-31.
  5. Tnibar A, Grubbe Lin K, Thurøe Nielsen K, Christophersen M, Lindegaard C, Martinussen T. Effect of a stent bandage on the likelihood of incisional infection following exploratory coeliotomy for colic in horses: A comparative retrospective study.. Equine Vet J 2013;45:564-9.
  6. Coomer R, Mair T, Edwards G, Proudman C. Do subcutaneous sutures increase risk of laparotomy wound suppuration?. Equine Vet J 2007;39:396-9.
  7. Torfs S, Levet T, Delesalle C, Dewulf J, Vlaminck L, Pille F. Risk Factors for Incisional Complications after Exploratory Coeliotomy in Horses: Do Skin Staples Increase the Risk?. Vet Surg 2010;39:616-20.
  8. Smith L, Mellor D, Marr C, Reid S, Mair T. Incisional complications following exploratory coeliotomy: does an abdominal bandage reduce the risk?. Equine Vet J 2007;39:277-83.
  9. Durward-Akhurst S, Mair T, Boston R, Dunkel B. Comparison of two antimicrobial regimens on the prevalence of incisional infections after colic surgery.. Veterinary Record 2012;172:287.
  10. Mueller T, Loos M, Haller B, Mihaljevic A, Nitsche U, Wilhelm D. Intra-operative wound irrigation to reduce surgical site infections after abdominal surgery: a systematic review and meta-analysis.. Langenbeck's Archives of Surgery 2015;400:167-81.
  11. Boekema B, Pool L, Ulrich M. The effect of a honey based gel and silver sulphadiazine on bacterial infections of in vitro burn wounds.. Burns 2013;39:754-9.
  12. Maruhashi E, Braz B, Nunes T, Pomba C, Belas A, Duarte-Correia J. Efficacy of medical grade honey in the management of canine otitis externa - a pilot study.. Vet Dermatol 2016;27:93-e27.
  13. Mandel H, Sutton G, Abu E, Kelmer G. Intralesional application of medical grade honey improves healing of surgically treated lacerations in horses.. Equine Vet J 2019;52:41-5.
  14. Postmes T, Van Den Bogaard A, Hazen M. Honey for wounds, ulcers, and skin graft preservation.. The Lancet 1993;341:756-7.
  15. McLoone P, Warnock M, Fyfe L. Honey: A realistic antimicrobial for disorders of the skin.. J Microbiol Immunol Infect 2016;49:161-7.
  16. Sutton GA, Dahan R, Turner D, Paltiel O. A behaviour-based pain scale for horses with acute colic: Scale construction.. Vet J 2013;196:394-401.
  17. Hoaglund E, Hess A, Hassel D. Retrospective evaluation of the effect of intravenous fluid administration on development of postoperative reflux in horses with colic (2004-2012): 194 horses.. J Veterinary Emerg Critical Care 2018;28:566-72.
  18. Magiorakos AP, Srinivasan A, Carey RB, Carmeli Y, Falagas ME, Giske CG. Multidrug-resistant, extensively drug-resistant and pandrug-resistant bacteria: an international expert proposal for interim standard definitions for acquired resistance.. Clin Microbiol Infect 2012;1(18):268-81.
  19. Bender R, Blettner M. Calculating the “number needed to be exposed” with adjustment for confounding variables in epidemiological studies.. J Clin Epidemiol 2002;55:525-30.
  20. Darnaud S, Southwood L, Aceto H, Stefanovski D, Tomassone L, Zarucco L. Are horse age and incision length associated with surgical site infection following equine colic surgery?. Vet J 2016;217:3-7.
  21. Johns I, Tennent-Brown B, Schaer BD, Southwood L, Boston R, Wilkins P. Blood culture status in mature horses with diarrhoea: a possible association with survival.. Equine Vet J 2009;412:160-4.
  22. Mattila E, Arkkila P, Mattila P, Tarkka E, Tissari P, Anttila V. Extraintestinal Clostridium difficile Infections.. Clin Infect Dis 2013;57:e148-e153.
  23. Gupta A, Patel R, Baddour L, Pardi D, Khanna S. Extraintestinal Clostridium difficile Infections: A Single-Center Experience.. Mayo Clin Proc 2014;89:1525-36.
  24. Steinman A, Masarwa S, Tirosh-Levy S, Gleser D, Kelmer G, Adler A. Methicillin-resistant Staphylococcus aureus spa type t002 outbreak in horses and staff at a veterinary teaching hospital after its presumed introduction by a veterinarian.. J Clin Microbiol 2015;53:2827-31.
  25. Shnaiderman-Torban A, Paitan Y, Arielly H, Kondratyeva K, Tirosh-Levy S, Abells-Sutton G. Extended-Spectrum β-Lactamase-Producing Enterobacteriaceae in Hospitalized Neonatal Foals: Prevalence, Risk Factors for Shedding and Association with Infection.. Animals 2019;9:600.
  26. Blaser G, Santos K, Bode U, Vetter H, Simon A. Effect of medical honey on wounds colonised or infected with MRSA.. Journal of Wound Care 2007;16:325-8.

Citations

This article has been cited 10 times.
  1. Chrysostomou D, Papanikolaou GE, Boshoff L, Mbele T, Pokorná A, Holubová A, Wagener FADTG, Cremers NAJ. Uncovering the Advantages of Foam Dressings with Active Ingredients. Pharmaceuticals (Basel) 2025 May 22;18(6).
    doi: 10.3390/ph18060768pubmed: 40573165google scholar: lookup
  2. Griessel TS, Muñoz Morán JA, Byaruhanga C, Smit Y. A single-centre retrospective study of surgical site infection following equine colic surgery (2013‒2021). Vet Rec 2025 May 17;196(10):e5227.
    doi: 10.1002/vetr.5227pubmed: 40123113google scholar: lookup
  3. Li Y, Gao L, Fan S. The characteristics of surgical site infection with class I incision in neurosurgery. BMC Surg 2025 Mar 12;25(1):97.
    doi: 10.1186/s12893-025-02825-9pubmed: 40075338google scholar: lookup
  4. Isgren CM, Pinchbeck GL, Salem SE, Hann MJ, Townsend NB, Cullen MD, Archer DC. Evaluation of a stent dressing and abdominal bandage on surgical site infection following emergency equine laparotomy: A randomised controlled trial. Equine Vet J 2025 Nov;57(6):1466-1477.
    doi: 10.1111/evj.14482pubmed: 39967458google scholar: lookup
  5. Lardenoije CMJG, van Riel SJJM, Peters LJF, Wassen MMLH, Cremers NAJ. Medical-Grade Honey as a Potential New Therapy for Bacterial Vaginosis. Antibiotics (Basel) 2024 Apr 17;13(4).
    doi: 10.3390/antibiotics13040368pubmed: 38667044google scholar: lookup
  6. Chatzimisios K, Tsioli V, Brellou GD, Apostolopoulou EP, Angelou V, Pratsinakis ED, Cremers NAJ, Papazoglou LG. Evaluation of the Effectiveness of Medical-Grade Honey and Hypericum Perforatum Ointment on Second-Intention Healing of Full-Thickness Skin Wounds in Cats. Animals (Basel) 2023 Dec 21;14(1).
    doi: 10.3390/ani14010036pubmed: 38200767google scholar: lookup
  7. Terschuur JA, Coomer RPC, McKane SA. Administration safety of medical-grade honey (MGH) in septic synovial structures in horses: 3 cases. Can J Vet Res 2023 Apr;87(2):153-156.
    pubmed: 37020573
  8. Bocoum A, Riel SJJMV, Traoré SO, Ngo Oum Ii EF, Traoré Y, Thera AT, Fané S, Dembele BT, Cremers NAJ. Medical-Grade Honey Enhances the Healing of Caesarean Section Wounds and Is Similarly Effective to Antibiotics Combined with Povidone-Iodine in the Prevention of Infections-A Prospective Cohort Study. Antibiotics (Basel) 2023 Jan 5;12(1).
    doi: 10.3390/antibiotics12010092pubmed: 36671293google scholar: lookup
  9. Mthanti SM, Pelle G, Cremers NAJ. L-Mesitran Foam: Evaluation of a New Wound Care Product. Case Rep Dermatol Med 2022;2022:4833409.
    doi: 10.1155/2022/4833409pubmed: 35464882google scholar: lookup
  10. Marais HJ, Glyphis ZG, Cremers NAJ. Medical grade honey: Hope for wounded white rhinos. Vet Anim Sci 2021 Sep;13:100196.
    doi: 10.1016/j.vas.2021.100196pubmed: 34471724google scholar: lookup
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