Tropical honey for the treatment of diabetic foot ulcer: A randomized controlled clinical trial

Tropical honey has been used for the treatment of ulcers since ancient times. But there is less medical evidence supporting this. Hence this research was planned to study the efficacy, safety and cost-effectiveness of tropical honey in treating Wagner grade 1 and grade 2 diabetic foot ulcers and compare it with povidone-iodine. We conducted an open-labeled randomized controlled clinical trial at a tertiary care hospital. It included patients with diabetic foot ulcers of Wagner grade 1 and 2 of at least two weeks duration. 80 patients were randomly assigned to either tropical honey dressing or povidone-iodine dressing once a day or once in two days. The primary outcome assessed was a percentage reduction in ulcer size at the end of six weeks in both groups. The secondary outcomes were ulcer depth, slough quantity, exudate, granulation score, microbiological clearance, cost-effective analysis and incidence of adverse effects. The tropical honey group had a significantly (p=0.023) reduced ulcer size (82.45 +/- 16.79%) compared to povidone-iodine (72.67 +/- 20.19%). It had a significantly (p=0.014) greater number of patients (n=13) with a completely healed wound at the end of six weeks compared to povidone-iodine (n=4). The tropical honey group had more patients with better slough and granulation scores. Tropical honey can therefore be used effectively for treating Wagner grade 1 diabetic foot ulcers with the added advantage of better cost-effectiveness and strong antibacterial action. Study was registered in the clinical trial registry of India.