Study protocol: efficacy of stingless-bee kelulut honeydressing compared to medical-grade manuka honey inthe treatment of diabetic foot ulcer

Background: The increasing prevalence of diabetes has contributed largely to the incidences of diabetic foot ulcerations worldwide. Chronic wound such as diabetic foot ulcer (DFU) takes longer time to heal with conventional treatment, gets infected, resistant to antibiotics, and leads to gangrene, even lower limb amputations. Managing DFU has become a challenge for clinicians and a serious healthcare burden with devastating consequences for the patients. The evolution in chronic wound management has led to the resurgence of traditional remedy like honey to improve healing outcomes and reduce foot complications. Topical dressing using medical-grade manuka honey had shown positive healing outcomes due to its antibacterial, anti-inflammatory and antioxidant properties. However, research on stingless-bee honey locally known as kelulut honey has yet to progress into significant wound healing evaluations despite having higher antioxidant properties. Thus, this study is aimed to evaluate the efficacy of kelulut honey as compared to medical-grade manuka honey in the treatment of DFU Method: This experimental study will include 60 participants recruited in a tertiary teaching hospital, Medical Centre (UMMC). All sloughy DFU will be debrided with maggot therapy and divided into Group1(intervention group treated with kelulut honey) and Group 2 (control group treated with medical-grade manuka honey). Follow up will be done for 2 weeks with wound measurement at baseline, day 7 and 14 to determine the healing rate. Discussion: The outcome of the study may provide the much-needed clinical evidence for kelulut honey to be considered for wound healing and future research could establish kelulut honey as an alternative topical dressing for DFU