331 Honey-impregnated gauze versus amniotic membrane in the treatment of burns zyxwvutsrqponmlkjihgfedcbaZYXWVU M. Subrahmanyam Department of Surgery, Dr V. M. Medical College, Solapur, Maharashtra, India zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPON A prospective randomized clinical study to compare honey-impregnated gauze with amniotic membrane dressing zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA in partial thickness bums was carried out. Sixty-four patients were studied Forty of them were treated with honey-impregnated gauze and zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA 24 w er e t r eat ed with amniotic membrane. The burns treated with honey healed zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA earlier as compared to the amniotic membrane (mean 9.4 us 17.5 days) (P< 0.001). Residual scars were noted in 8 per cent of patients treated with honey-impregnatedgauze and in 16.6 per cent of cases treated with amniotic membr ane (P < 0.001). Burns (1994) 20, (4), 331-333 Introduction Honey consists of a concentrated solution of simple sugars and has been used as an adjunct for acceleration of wound healing. It has been used in bums to control bacterial infection and to promote epithelialization’*2. Wounds epithelialize more rapidly in a moist environment3p4 and honey provides such an environment acting as a viscous barrier to wound invasion and fluid 10s~~. Amniotic membrane has been used as a biological dressing for covering burns and found to prevent infection and promote epithelializatiorF*. Thus amniotic membrane and honey, which are easily available and cheap, have been found to be helpful in burns. In order to evaluate the clinical use of honey in the treatment of burns, a prospective trial was carried out to compare honey-impregnated gauze dressing with amniotic membrane. Patients and methods Sixty-four patients with partial skin thickness burns involv- ing less than 40 per cent of the body surface and admitted within 6 h of injury to the General Hospital, Solapur during the period June 1991 to July 1992 were included in this study. After initial treatment, patients were allotted to the two groups at random. In group I (n = 40) honey- impregnated gauze was applied after washing the wounds with normal saline. In group 2 (n = 24) amniotic membrane obtained in a fresh condition after Caesarean section or normal delivery was used. The amniotic membrane, after separation from the chorion and placenta, was washed with normal saline. The membrane was then applied after washing the bum wound with normal saline. In all patients culture swabs were obtained from the wounds at the time of admission. 0 1994 Butterworth-Heinemann Ltd 0305-4179/ 94/ 040331-03 The honey-impregnated gauze was prepared by dipping sterile gauze in unprocessed and undiluted honey. The gauze was applied to the wound and then covered with an absorbent dressing. These wounds were inspected every 2 days until healed. In contrast the patients treated with amniotic membrane had a first wound inspection on day 8, when the dressing was changed and then every second day until healed. The following observations were recorded in all patients: leakage of exudate from the dressing, skin reactions, infection and time for wound healing. Pain was assessed during the change of dressing in both groups, by two separate observers. The patient or the parent, if the patient was a child, was given a questionnaire listing four adjectives - pain not significant classified as none, mild, moderate and severe as described by Poulsen et al9 The pain scores judged by the patients, or in the case of children by their parents, were recorded and the percentage of observations in each category calculated. If there was clinical evidence of infection, the dressing was removed and a new dressing was applied after cleaning. Bacterial culture and sensitivity determinations were per- formed in all wounds on days 8 and 21 or until the wounds healed. The time taken for complete healing was noted in both groups. The patients were seen 3 months after injury in order to evaluate any residual scarring by testing the range of movements of the affected parts, classifying them as major or minor9. The data were analysed using the chi- square (x2) test. Results Among the 64 patients, 43 were males and 21 females. The youngest patient was 3 years old and the oldest was 62 years. Sixty patients were in the age group 21-30 years. The bum surface area ranged from 10 to 40 per cent (TBSA) (mean 18.5 per cent) in Group 1 and 11.5 to 40 per cent (mean 19.4 per cent) in Group 2. TableZ shows the patient data. In the patients treated with honey-impregnated gauze, the wounds showed considerable signs of healing by 10 days in 23 patients and by day 15 in 10 patients. Thus 82 per cent of patients had actively healing wounds by day 15 (mean 9.4 days). In patients treated with amniotic mem- brane, the wounds healed between 11 and 30 days (mean 17.5 days) (TubZe II). The time taken for wound healing differed significantly between the two groups (PC 0.001). In the 40 patients in Group 1, 28 patients showed positive