Intraincisional medical grade honey decreases the prevalence of incisional infection in horses undergoing colic surgery: A prospective randomised controlled study.
Authors: Gustafsson Kajsa, Tatz Amos J, Slavin Roni A, Sutton Gila A, Dahan Roee, Ahmad Wiessam A, Kelmer Gal
Journal: Equine veterinary journal
Summary
# Editorial Summary: Medical Grade Honey for Colic Surgery Incisions Incisional infection remains a significant post-operative complication following equine colic surgery, yet intraoperative local prophylaxis has received limited investigation. Gustafsson and colleagues conducted a prospective randomised controlled trial with 89 horses undergoing colic surgery, allocating animals 1:1 to receive either medical grade honey gel (L-Mesitran Soft®) placed on the closed linea alba before subcutaneous closure, or standard closure without treatment. The treatment group demonstrated a substantially reduced incisional infection rate of 8.2% compared with 32.5% in controls (P = .02), with an adjusted odds ratio of 0.2—meaning treated horses were approximately five times less likely to develop infection, requiring treatment of only 4.7 horses to prevent one infection. Post-operative monitoring at five intervals over three months identified younger age and post-operative diarrhoea at 48 hours as significant risk factors for infection, whilst no adverse effects from honey application were recorded. For practitioners, this evidence suggests intraoperative application of medical grade honey gel represents a simple, safe and potentially highly effective adjunct to standard surgical technique that may meaningfully reduce a common source of post-operative morbidity in colic patients.
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Practical Takeaways
- •Consider intraoperative application of medical grade honey gel to the linea alba in colic surgery cases as a safe, simple prophylactic measure that reduces infection risk by approximately 75%
- •Be particularly vigilant about post-operative infection risk in younger horses and those developing diarrhoea within 48 hours of surgery, as these are strong independent risk factors
- •This low-cost intervention requires no special equipment and adds minimal operative time while potentially reducing costly post-operative complications and extended hospitalization
Key Findings
- •Medical grade honey gel applied intraoperatively to the linea alba reduced incisional infection rate from 32.5% to 8.2% (P = 0.02)
- •Adjusted odds ratio for infection prevention with honey treatment was 0.2 (95% CI: 0.07–0.8), requiring treatment of 4.7 horses to prevent one incisional infection
- •Younger age (OR = 27) and post-operative diarrhoea at 48 hours (OR = 20) were significant risk factors for incisional infection
- •No adverse effects associated with intraincisional honey gel application were observed during the 3-month follow-up period