Manuka Honey in Craniofacial Wound Management: A Narrative Review

Craniofacial wounds present unique management challenges owing to the aesthetic significance of the facial region, proximity to vital structures, risk of contamination from oral flora, and the frequent presence of exposed bone or hardware. Manuka honey, derived from the Leptospermum scoparium plant, possesses well-documented antimicrobial, anti-inflammatory, and wound healing properties attributable primarily to its methylglyoxal content, osmotic activity, and low pH. However, no review has specifically addressed its application in the craniofacial context.

A narrative review was conducted using PubMed, Scopus, and Web of Science databases. Search terms combined honey-related keywords with craniofacial and head-and-neck terminology. Clinical studies, case reports, randomized controlled trials, and relevant general wound care reviews were included. The Scale for the Assessment of Narrative Review Articles (SANRA) was used as a quality framework.

Evidence supporting the use of Manuka honey in the craniofacial region was identified across several wound categories, including scalp defects with exposed calvarium, head and neck oncologic reconstruction wounds, oral and maxillofacial infections, partial flap necrosis, facial surgical wounds, and burns. In vitro data also suggest selective cytotoxicity against tumor cells, raising the possibility of a dual wound healing and antitumor role in postoncologic surgical wounds. Most available evidence remains at the level of case reports and small series, with only one randomized controlled trial conducted specifically in head and neck wounds.

Manuka honey represents a safe, cost-effective, and promising adjunctive wound care modality for the craniofacial surgeon. Registered medical-grade products are ideal where available, but UMF-certified commercial Manuka honey with verified antimicrobial ratings offers a scientifically rational alternative in regions where medical-grade products are not accessible. Prospective studies evaluating Manuka honey in specific craniofacial wound types are warranted.