British Journal of Oral and Maxillofacial SurgeryVolume 46, Issue 1, January 2008, Pages 55-56

Bhavin G.VisavadiaJanHoneysettMartin H.DanfordMaxillofacial Unit, Royal Surrey County Hospital, Egerton Road, Guildford Surrey, UK

Accepted 21 September 2006, Available online 20 November 2006


We have been using Manuka honey tulle dressings (Activon) for the last year in our wound care clinic and wards, and have had success in treating recalcitrant surgical wounds within the maxillofacial unit, which had proved to be resistant to antibiotics. The honey-impregnated dressing is applied directly on to the surface of the wound and is then covered in a second absorbent layer to contain the honey. Dressings are changed every 2–3 days.

Case 1

An 80-year-old man had a split skin graft harvested from his upper arm in May 2005 (Fig. 1A). The wound was managed until September 2005 with routine wound dressings but remained contaminated with MRSA. The first Manuka honey dressing was applied at the end of September 2005 and the wound had healed 2 weeks later (Fig. 1B).

Case 2

A 64-year-old man had a radial forearm flap donor site grafted with an abdominal full thickness skin graft. The wound was infected with MRSA on removal of the dressings 7 days postoperatively (Fig. 2A).Treatment consisted of dressings on alternate days with Manuka honey tulle, and local debridement of eschar when necessary. The wound healed without further complications 5 weeks later (Fig. 2B).