Honey versus povidone dressing in accelerating the diabetic foot ulcer healing process

Abstract

A brief overview of the topic: Globally, diabetic foot ulcers are the most common diabetic complication which decreases the individual’s quality of life, while giving rise to an economic burden (Gojka, 2020). The diabetic foot ulcer prevalence in the diabetic population is about 4 to 10%, with an increased probability in older individuals. Internationally, honey dressing has been widely used as part of the healing process; however, further studies are still needed on the healing process of diabetic foot ulcers. Therefore, this study explored the effect of honey vs povidone dressing to accelerate the healing process in DFU. The Research Question: Does honey dressing accelerate the healing process compared to povidone dressing in adult diabetic foot ulceration? PICO Elements: Population (P) Diabetic adults with foot ulcers, Intervention (I) Honey dressing, Comparison (C) Povidone dressing, Outcome (O) Acceleration of the healing process Inclusion criteria applied: Randomised controlled trials (RCTs) and quasi-experimental studies, studies published only in English and in the last eleven years (2007-2018), participants must be humans older than 18 of both genders, diabetic patients, studies including diabetic foot ulcer, and full-text articles. Exclusion criteria applied: Articles that lacked level of evidence, studies not published in English and before 2007, young participants under 18 years, animal studies, non-diabetic patients, articles not related to diabetic foot ulcers, and articles without full text. Outcome of the search activity: The outcome of the search activity resulted in five key studies, namely, four randomised controlled trials and one quasi-experimental study. Method of appraisal used: Different key terms were identified and applied to various online databases, including PubMed and EBSCO, and were combined with Boolean Operators to create a search strategy. Search results were narrowed down by applying limiters. The PRISMA checklist was utilised to eliminate unrelated studies. The CASP tool was further utilised for the critical appraisal of the studies. Main Results: The chosen studies consisted of four Randomised Controlled Trials and one Quasi-Experimental Study. Four studies were found to be statistically significant to honey dressing accelerating the ulcer healing process when compared with povidone dressing. Although one study was not statistically significant, the outcome was that the intervention has better benefits than the comparison. Main Conclusion: All five studies came to one conclusion, that honey dressing does accelerate the healing process in diabetic foot ulcers. However, further research and large multicentre studies are still needed to guarantee the effect of honey on diabetic foot ulcers. Implications and Recommendations: Further research is required to further develop the effectiveness of honey dressing in accelerating diabetic foot ulcers by using larger sample sizes and multicentre trials. Locally, it is suggested that diabetic foot screening should be performed according to the risk of the individual, and not annually. Furthermore, for management and practice, a set of evidence-based guidelines should be provided for healthcare professionals to follow.