Trigona honey effect on wound pH and healing in diabetes-related foot ulcers: A case series

Diabetes-related foot ulcers (DFUs) often become chronic due to prolonged inflammation and alkaline wound pH. Trigona honey is a potential therapy due to its low pH and antimicrobial properties. This case series explores pH dynamics and the effect of Trigona honey therapy on healing of DFUs and offers insights into optimizing treatment strategies to improve healing outcomes.

Four patients with DFUs were treated with Trigona honey and followed until healing or 8 weeks. Wound bed pH was measured and wound characteristics were assessed with the DMIST tool at each follow-up visit. In two patients who healed, the inflammatory phase lasted 11 and 6 days, and the wound bed was acidic during most of the proliferative phase. In two patients who did not heal within 8 weeks, the inflammatory phase lasted 27 and 25 days, and the wound bed was alkaline for most of the proliferative phase.

Ulcers that did not heal had a longer inflammatory phase and wound bed pH was more alkaline than in ulcers that healed. Although Trigona honey might not directly affect the pH of the wound bed, treatment should be modified if alkaline granulation tissue is observed.