The Effect of Dilution on the Rate of Hydrogen Peroxide Production in Honey and Its Implications for Wound Healing

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Abstract
Objective: Honey is an effective antiseptic wound dressing, mainly the result of the antibacterial activity of hydrogen peroxide that is produced in honey by the enzyme glucose oxidase. Because the rate of production of hydrogen peroxide is known to vary disproportionately when honey is diluted, and dilution of honey dressings will vary according to the amount of wound exudate, it is important to know more about the production of hydrogen peroxide at different concentrations of honey. Design: The rates of hydrogen peroxide production by honey with respect to honey dilution were measured in eight different samples of honey from six different floral sources. Settings: Honey Research Unit, Waikato University, Hamilton, New Zealand. Main Results: The maximum levels of accumulated hydrogen peroxide occurred in honey solutions diluted to concentrations between 30% and 50% (v/v) with at least 50% of the maximum levels occurring at 15-67% (v/v). This is equivalent to a 10 cm × 10 cm dressing containing 20 mL of honey becoming diluted with 10 to 113 mL of wound exudate. Maximum levels of hydrogen peroxide reached in the diluted honeys were in the range of 1-2 mmol/L. Conclusion: Significant antibacterial activity can be maintained easily when using honey as a wound dressing, even on a heavily exuding wound. Concentrations of hydrogen peroxide generated are very low in comparison to those typically applied to a wound, thus, cytotoxic damage by hydrogen peroxide is very low.