Honey dressing for diabetic foot ulcers: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND

To systematically evaluate the efficacy and safety of honey dressing compared to conventional dressings in the treatment of DFUs.

METHODS

We conducted a systematic review and meta-analysis following PRISMA guidelines. PubMed, BIOSIS, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), and Google Scholar internet were searched from inception to Jan 31, 2026 for RCTs comparing honey dressing with conventional dressings in DFU patients. Primary outcomes were complete wound healing rate and time to complete healing. Risk of bias was assessed using the Cochrane RoB 2.0 tool. The quality of evidence was graded through the Grading of Recommendations Assessment Development and Evaluations (GRADE) approach.

RESULTS

Sixteen RCTs involving 1423 participants were included. The sample sizes ranged from 23 to 348 participants. The follow-up duration varied from 4 to 24 weeks. Meta-analysis showed that honey dressing significantly improved the complete healing rate (OR 2.28, 95% CI 1.76 to 2.95) and reduced the time to complete healing (MD -4.38, 95% CI -8.06 to -0.71) compared to controls. According to the GRADE system, the overall quality of evidence for the outcomes of time to healing was rated as 'Low', and the quality of evidence for the outcomes of healing rate was rated as 'moderate'.

CONCLUSION

Honey dressing is a safe and more effective intervention for DFUs than conventional dressings, associated with significantly improved healing rates and faster healing time.

SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251244450, identifier CRD420251244450.