The wound-healing and antimicrobial properties of honey have been well-documented since ancient times. In a recent study, veterinarians determined they can use pectin-honey hydrogels (PHH), which combine honey with pectin—a natural fruit-derived soluble fiber that acts as a gelling agent—to promote wound healing and reduce the incidence of infection in horses.

“We aimed to evaluate the effectiveness of manuka-honey-based hydrogels in preventing surgical site infections in horses undergoing emergency laparotomy,” explained Gessica Giusto, DVM, PhD, and Marco Gandini, DVM, PhD, in an email to TheHorse.com. Giusto and Gandini are associate professors at the University of Turin’s Veterinary Teaching Hospital, in Italy.

An Alternative to Antibiotic Use in Horses

In recent years antibiotic resistance has become a growing complication in equine wound healing, Giusto said. Applying PHHs to surgical wound sites could provide a safe and effective alternative to more common antibiotic-based wound management methods.

“Our study investigated this alternative approach and sought to provide a solution that could reduce the use of antimicrobials, thereby helping to address the broader challenge of antimicrobial resistance,” said Giusto.

Giusto and her team compared postoperative wound infection rates in 36 horses, divided equally into two groups. Following laparotomy (exploratory colic surgery), the researchers applied PHH to the abdominal surgical incisions of the horses in the treatment group. They left the surgical incisions of horses in the control group untreated.

The researchers recorded a significant difference in infection rates between the two groups, with an infection incidence of only 5.5% in the PHH group compared to 38.9% in the control group.

“PHHs adhere to the wound site more effectively than liquid honey, reducing the risk of movement beyond the treatment area during application,” said Giusto. “This adherence simplifies application during surgery, as the PHH remains within the wound boundaries. PHH also combines the antibacterial properties of honey with the capacity to maintain a moist and acidic environment, favorable to wound healing-conditions that liquid honey may struggle to sustain consistently.”

Indeed, using PHH instead of other more common wound management treatments, Giusto said, could help reduce the risk of antibiotic resistance associated with more traditional treatments. Pectin-honey hydrogels also significantly reduce surgical site infection rates, speed up the overall wound healing process, and enhance healing outcomes.

Take-Home Message

Using PHH following emergency laparotomy in horses effectively reduced the incidence of surgical site infection in the treatment group. “Importantly, we did not observe any visible complications, indicating that PHH application appears to be safe,” Giusto said. However, the researchers said they agree more studies are needed in a broader equine population to fully explore the efficacy and safety of PHH.

The study, “Pectin-honey hydrogel to prevent laparotomy surgical site infection in horses: A pilot study” appeared in the Journal of Equine Veterinary Science in August 2024.