Manuka Honey and how it works.

Summary of recent research into medical grade Manuka Honey and how it works in the application of wound care in horses.

Manuka honey has been used for hundereds of years in forms of wound healing and antibacterial remedies.


Manuka honey has a unique antimicrobial activity not due to hydrogen peroxide. Manuka honey has been proven to have a topical broad-spectrum antimicrobial action, effective against over 60 strains of bacteria of both gram positive and gram negative, and includes resistant strains too! 


These antimicrobial properties are further enhanced by the presence of methylglyoxal (MGO) in Manuka honey produced from dihydroxyacetone in the nectar of the Manuka flower. MGO is responsible for most of the antimicrobial activity of Manuka honey. This non-peroxide antimicrobial activity of Manuka honey is referred to as its Unique Manuka Factor (UMF). This is a standardised rating system for measuring the level of antimicrobial potency of Manuka honey on a scale from 5-26.


The higher the UMF grade, the greater the antimicrobial activity. As the UMF grade rises, so does the price and it can become very expensive.


Various studies have shown that a rating of 10 or more is usually all that is required to provide sufficient antimicrobial activity in the wound environment. This is useful to know when there are financial constraints, as using a lower UMF may ease financial burden without risking failure of treatment.

For equine wound care select a Manuka honey product that has a UMF of 10 or higher. A UMF of 10 corresponds to a MGO of 263. A UMF of 16 corresponds to a MGO of 572.

  • UMF10–15: useful therapeutically

  • UMF16–30: superior activity with high potency​


Although most interest is focused on its antimicrobial property, more recent evidence indicates that Manuka honey also has great anti-inflammatory effects.

Manuka Honey increases production of inflammatory cytokines in leukocytes, aiding the growth of new epidermal tissue and blood vessels, which encourages the formation of healthy granulation tissue.


However, for this effect to take place the Manuka honey would need to be applied as soon as possible after injury. 

ACTIVE Manuka honey also reduces inflammation by drawing exudate and lymph out of the wound tissues and associated micro-capillaries, which physically reduces swelling, inflammation and the symptomatic pain associated with the anti-inflammatory response.


The Manuka honey needs to be applied once and ideally twice a day in uncovered wounds and at each bandage change in covered wounds.

Manuka honey should be applied for the first two weeks of a wound and possibly even longer.

References - 

Everything You Need to Know About Using Manuka Honey In Equine Wound Care. (2018, January 1). Equestology Sport Horse Science. https://equestology.com.au/horsecarescience/2017/12/29/everything-that-you-need-to-know-about-manuka-honey-and-wound-care

Kennedy, C. (2018). The role of Manuka honey in second intention healing of wounds of the equine distal limb. 8(11), 669–674.

Tsang, A. S., Dart, A. J., Dart, C. M., & Jeffcott, L. B. (2018). Mechanisms of action of manuka honey in an equine model of second intention wound healing: Current thoughts and future directions. Medical Research Archives, 6(7), Article 7. https://esmed.org/MRA/mra/article/view/1816

 

Healing with Honey

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Day 1

Graze which has degloved  through the 3 dermal layers

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Day 3

The inflammatory phase.  Swelling occurs as WBCs migrate to the wound and clean out foreign material and  bacteria.

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Day 7

Healthy granulation tissue is formed with no proud flesh, and no slough or exudate is present. Swelling is completely gone. Epithelialisation is already forming around the wound edges.

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Day 21

Wound contraction and the process of epithelialisation is almost complete. Still no excessive granulation tissue.