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Table 1 The healing properties of natural unheated honey

From: Does application of honey improve surgical outcome in pilonidal cyst excision with secondary intention healing? A prospective randomized placebo-controlled clinical trial

Cause

Effect

Stimulation of inflammatory cytokines (TNF-α, IL-1β, and IL-6 release from Mono-Mac 6 (MM6) cells (A monocytic cell line)

Healing and tissue repair

Proliferation and activation of peripheral blood B and T lymphocytes

Healing and tissue repair

Glucose oxidase catalyzes the oxidation of glucose to gluconic acid and release hydrogen peroxide (H2O2), which causes a decrease in the honey pH and ruins the

outer membrane of the bacteriae

Anti-bacterial activity and stimulates the wound healing process

Methylglyoxal

Anti-bacterial activity

Viscosity and hyperosmolarity

Anti-bacterial activity helps to absorb exudate and provide a protective barrier to prevent infection

Varying concentrations of antioxidants (flavonoids, ascorbic acid, carotenoids, catalase, peroxidase, and phenolic acids)

Anti-oxidant properties may be beneficial to wound healing

Provides a moist environment (physical properties)

Create a moist wound healing environment that does not stick to the underlying wound tissues

Acidity

Reduce protease activity, increase fibroblast activity, and increase oxygen release, assist in the bacterial-killing action of macrophages, aiding wound healing, but increase pain

Increase nitric oxide (NO) production

Affect immunity, bacterial infections, and wound healing

Inhibitory effect on prostaglandins

Affect inflammation, pain, immunity, and wound healing

Nutritional composition (glucose, fructose, sucrose, minerals, vitamins, antioxidants, amino acids, and other products)

Wide biological and therapeutic effects

Enhancing wound contracture

Healing and tissue repair

Increased granulation tissue formation

Healing and tissue repair