External Applications in Anthroposophic Nursing

Honey and Cabbage Wound Care

Kind of substance

Honey and white cabbage

Guiding principle

There is a long tradition of using honey to treat chronic wounds and it has become more appreciated again in recent times. Research has identified a wide range of properties that promote wound healing, some of which are mentioned here:

  • Favorable influence on the moisture environment of the wound due to the high sugar content and the resulting hyperosmolarity
  • Supports enzymatic wound cleansing
  • Broad antibacterial, antiviral and fungicidal effect depending on composition
  • Promotion of granulation and epithelization


White cabbage leaves have the property of mobilizing fluid congestion, even in cases of edema or lymph congestion around wounds; therefore, white cabbage leaves are also used for joint swelling and breast gland swelling (in connection with milk congestion). It can often be observed that wound dressings with white cabbage leaves will initially cause increased exudation – which should not then be misinterpreted as worsening the course. White cabbage leaves are also well suited as wound covers to prevent sticking. In addition, the leaves contain essential oils which have an antimicrobial effect.

Honey and white cabbage leaves can also be well combined in the treatment of wounds: the honey can be effective on the wound surface and deep down, while cabbage and appropriate dressings can be used to protect the wound from the outside.

Indications

  • Bedsores
  • Ulcus cruris
  • Chronic wounds
  • Delayed wound healing

Instructions

Particularities:
Caring for chronic wounds requires special, ongoing attention – it clearly has a negative effect on the course of a wound when the treatment methods and caregivers are often changed. The patient should agree to the treatment methods and be involved as much as possible. Usually wounds get worse when they are neglected and when there is no agreement on treatment.
Note: Both honey and cabbage can temporarily cause a slight burning and pulling sensation in the wound.
Chronic wounds are an expression of a general problem. Therefore, the patient should always be under appropriate medical care with regard to his underlying diseases and the course of wound healing.
It is advisable to document the patient’s and physician’s agreement with the treatment method in writing, as well as record the course of the wound treatment in writing and with pictures.

Materials:

  • Mānuka Honey (native flower honey for diabetics), organic quality (pesticide-free), do not heat above 35°C (95°F), store in a jar
  • Organically grown white cabbage (Brassica oleracea); only the juiciest inner leaves are used
  • For storage, wrap the cabbage head in a damp cloth and store at room temperature


Instructions:
  • Clean the cabbage leaf with water (possibly with alcohol)
  • Cut out and remove the vein
  • Roll over the leaf with a glass bottle on a clean work surface until juice emerges
  • Cut the leaf to fit the wound
  • Apply honey to the wound surface in a thickness of about 1 millimeter, if necessary use alginate for dressing in case of heavy exudation and deeper wounds
  • Cover the wound with the cabbage leaf cut to the size of the wound and then dress the wound with sterile gauze compresses and plaster or gauze bandages


Follow-up:
  • Initially, the dressing is changed daily; if the wound is clean and well granulated, the interval between dressing changes can be extended
  • Honey residues can remain in the wound during dressing changes
  • If the dressing sticks to the wound, use more honey or shorten the intervals between dressing changes

Evidence
Well-proven in many patients
Dosage
As needed
Other recommended therapies
To support wound cleansing, it can be helpful to rinse the wound with Calendula essence diluted 1:10 (with sterile saline)
The formation of new tissue can be supported from the edge of the wound with an application of Calendula Intensive Skin Recovery (Calendula Wundsalbe WELEDA).
Warning
The exudation-promoting effect of the white cabbage at the beginning of the treatment is not equivalent to a deterioration of the healing process

Case example

Example case 1
A case history involving white cabbage as a treatment is described in detail in the publications of H. Glaser (1995/2000 – see the bibliography below).

Example case 2
The use of honey is discussed in detail and presented in a case history in the publication of R. Zerm (2012 – see the bibliography below).

Author

BD

Bibliography

  • Caplan LM. Drawing action of cabbage leaves. Journal of Human Lactation 15.1 (1999): 7-8.
  • Dygut, Jacek, et al. Effect of Cabbage Wraps on the Reduction of Post-Traumatic Knee Exudates in Men. The Journal of Alternative and Complementary Medicine 24.11 (2018): 1113-1119.
  • Glaser H. Wundbehandlung in der anthroposophischen Medizin – eine Kasuistik; Der Merkurstab 4/1995.
  • Glaser H. Erfolgreiche Wundbehandlung. Aus der Praxis der anthroposophisch erweiterten Krankenpflege. 1st ed. Stuttgart: Urachhaus; 2000.
  • Glaser H. Anthroposophische Wundbehandlung. In: Lüder Jachens: Dermatologie Grundlagen und therapeutische Konzepte der Anthroposophischen Medizin; Salumed Verlag, Berlin 2012.
  • Grimme H. and Augustin M. Phytotherapy in chronic dermatoses and wounds: what is the evidence? Forschende Komplementarmedizin 6 (1999): 5-8.
  • Jull AB, et al. Honey as a topical treatment for wounds. Cochrane Database of Systematic Reviews 3 (2015)
  • Roberts KL, Reiter M, and Schuster D. A comparison of chilled and room temperature cabbage leaves in treating breast engorgement. Journal of Human Lactation 11.3 (1995): 191-194.
  • Zerm R, Jecht M, De-Malter P, et al. Treatment of diabetic foot syndrome with Manuka honey. European Journal of Integrative Medicine 2010; 2 (4): 258-259.
  • Zerm R. Integrative Behandlung chronischer Wunden unter besonderer Berücksichtigung des Honigs; Der Merkurstab 1/2012

Substances