Efficacy And Safety Of Honey Dressing In The Treatment Of Diabetic Foot Ulcers:A Meta Analysis

Objective:Honey dressing has been used for wounds treatment nearly thousands of years,which is mainly applied in burns,pressure ulcers,diabetic foot ulcers and so on.At present,there is no definite conclusion about the efficacy and safety of honey dressing in the treatment of diabetic foot ulcers.This study aims to explore the efficacy and safety of honey dressing in the treatment of diabetic foot ulcers through meta analysis.Methods:We searched Pubmed,EMbase,Web of Science,The Cochrane Library,CBM,CNKI,VIP Data,WanFang Data to collect randomized controlled trials about the honey dressing and other dressings in the treatment of diabetic foot ulcers from inception to December 2017.Patients with severe foot infection,sepsis,diseases and use of drugs that impact wound heading were not included.The primary outcomes were complete healing rate and mean healing time,secondary outcomes including percent of ulcers size reduction,complete sterile rate,amputation rate and side effect.Two reviewers independently searched,screened literature,extracted data and assessed the risk of bias of included studies.Meta analysis was performed using RevMan 5.3 software.Egger’s test and Begger’s test was used for publication bias plot.We used the GRADE profiler 3.6 system to evaluate the quality of evidence.The relative risk,standardized mean difference and 95%confidence intervals were calculated to estimate the efficacy and safety of honey dressing in the treatment diabetic foot ulcers.Results:A total of 8 RCTs involving 767 patients with diabetic foot ulcers were included in this study.The main results showed that honey dressing had higher complete healing rate(RR=1.32,95%CI=1.17 to 1.50,P<0.0001)and shorter healing time(SMD=-1.12,95%CI=-2.06 to-0.19,P=0.02)than conventional dressing.Honey dressing had higher percent of ulcers size reduction(SMD= 1.84,95%CI=0.27 to 3.42,P=0.02)and complete sterile rate(RR=2.63,95%CI=1.60 to 4.32,P=0.0001)than conventional dressing,while there was no significant difference between the two groups in terms of amputation rate(RR=0.55,95%CI=0.19 to 1.54,P=0.25).No serious side effect was reported in all the included studies.Conclusion:Honey dressing is a relatively safe and effective method in the treatment of diabetic foot ulcers.However,the results of this study need to be further verified by more high quality researches.