The role of intra-peritoneal honey administration in preventing post-operative peritoneal adhesions

OBJECTIVE(S): The accelerative effect of honey in the wound healing process is known. This effect is related to its specific physical properties of hygroscopicity, hypertonicity, lower pH and complex chemical composition. Because peritoneal healing is a kind of wound healing process we hypothesised that post-operative peritoneal adhesions (PPA) may be reduced with intra-peritoneal honey administration. STUDY DESIGN: The study was conducted with 40, 6-month-old, out-bred female Wistar albino rats with a mean weight of 197 +/- 12 g. The rats were divided into two equal groups. An adhesion model was constituted in the cecum and terminal ileum of all rats in each groups. Later the adhesion areas were washed with 0.9% NaCl solution and 5 ml of the same solution was left in the peritoneal cavity in the control group. The same area in the rats in the other group was covered with honey and 5 ml of honey was left in the peritoneal cavity of each animals. Ten days later the rats were sacrificed and the adhesions were graded according to their degree of severity. Statistical analysis was performed with the non-parametric Mann-Whitney U-test. RESULTS: In the control group, there were no rats with grade-0 or grade-1 adhesions but in the honey administered group there were six rats (30%) with grade-0 and 12 rats (60%) with grade-1 adhesions. In the control group, there were six rats (30%) with grade-2 and 14 rats (70%) with grade-3 adhesions. In the honey administered group while two rats (10%) with grade-2 adhesions were present, no rat with grade-3 adhesions was seen. In the comparison, the difference between the groups was found to be highly significant (P < 0.001). CONCLUSION(S): The wound healing accelerative effect and the mechanical barrier formed by the honey, since, it has a high density and, thus, absorbed slowly from peritoneal cavity, may be the reasons for its inhibitory effect on the PPA. This study indicates that though the mechanism is not clear intra-peritoneal honey administration reduces PPA.