SurgihoneyRO anticmicrobial wound gel is an approved medical device (dressing) for treating a wide range of acute and chronic wounds including: leg ulcers, diabetic foot ulcers, pressure ulcers, burns, skin graft sites and surgical wounds.

In 2017, the NHS through Public Health England's guidance on the treatment of common infections recognised Reactive Oxygen® wound gel (SurgihoneyRO) as a treatment for venous leg ulcers to reduce bacterial load and infection, explaining it could help reduce antibiotic use. (28 )

SurgihoneyRO(formerly known as Surgihoney) is a natural product that has been bioengineered to provide a managed and consistent level of antimicrobial activity. It supports the body's defence system to combat infection and stimulate healing.

Its broad-spectrum antimicrobial action comes from the release of hydrogen peroxide, a reactive oxygen species (ROS), at therapeutic levels to the infection site for a prolonged period. 6) Laboratory testing suggests this can be for up to three days.(1)

SurgihoneyRO is highly effective against common wound-infecting bacteria, including multi-drug resistant strains such as MRSA and Pseudomonas. Laboratory testing has also demonstrated antibiofilm action.(15) ROS promotes wound healing at a cellular level by acting as secondary messengers to cells involved in the repair process and new tissue generation.(13)

In a multi-centre clinical evaluation, SurgihoneyROwas observed to help a wide range of wounds progress toward healing - leg ulcers, pressure ulcers, surgical wounds, diabetic foot ulcers and trauma.(16)Read the paper.

SurgihoneyRO™ is a sterile, multi-action wound gel:

  • Effective de-sloughing agent which helps to clean the wound bed and prepare it for healing (16)
  • Provides a barrier to help keep a moist wound environment which aids healing
  • Broad spectrum antimicrobial action in vitro against Gram-positive, Gram-negative and multi-drug resistant bacteria, including MRSA and Pseudomonas aeruginosa (1)
  • Fast-acting - kills bacteria in vitro in as little as 30 minutes (1)
  • Prevents and disrupts biofilm in vitro(15,27)
  • Reduces pain & inflammation (16)
  • Provides nutrients (glucose) to stimulate granulation tissue formation and promote healing
  • Viscous nature protects and makes dressing changes easier (less painful)


Benefits of SurgihoneyROcompared to other antimicrobial agents

Hydrocolloid / Alginate products

Silver dressings

Antispectics (e.g. iodine, chlorhexidine)


Antimicrobial Yes, it has this property Yes, it has this property Yes, it has this property
Yes, it has this property
Yes, it has this property
Safe (non-toxic) Yes, it has this property Yes, it has this property
Promotes wound healing at a cellular level Yes, it has this property
Wound barrier Yes, it has this property Yes, it has this property Yes, it has this property
Moisture control Yes, it has this property Yes, it has this property Yes, it has this property
De-sloughing agent Yes, it has this property Yes, it has this property
Local wound nutrition

Yes, it has this property
Odour control Yes, it has this property Yes, it has this property
Pain Suppressant Yes, it has this property Yes, it has this property



Biofilms are communities of bacteria and other micro-organisms living within a self-secreted and protective matrix. The majority of chronic wounds are believed to contain a biofilm, which can impede healing and are highly resistant to antibiotics.

Scientists from the National Institute for Health Research (NIHR) Surgical Resconstruction and Microbiology Research Centre, a research arm of the NHS, demonstrated SurgihoneyROcan prevent and disrupt biofilms of 16 common wound-infecting bacteria, including MRSA and Pseudomonas aeruginosa (in vitro) (8, 15, 27)

Superior anti-biofilm action was observed compared to standard medical honeys and honey-impregnated dressings. SurgihoneyRO is comparable to silver-impregnated dressings in antimicrobial activity but without the toxic side-effects.(1, 15)

Read the paper here



1. Dryden M. Lockyer G. Kordo S. Cooke J. Engineered honey: in vitro antimicrobial activity of a novel topical wound care treatment. Journal of Global Antimicrobial Resistance 2014. 10.1016/j.jgar.2014.03.006

2. Dryden MS. Hudgell. Saeed K. Dryden AWS. Brooks J. Cooke J. Surgihoney - honey wound treatment: first report of in-vitro activity and early clinical evaluation. Federation of Infection Societies. Birmingham UK,2013.

3. Dryden M. Goddard C. Madadi A. Heard M. Saeed K. Cooke J. Bioengineered Surgihoney as an antimicrobial wound dressing to prevent Caesarean wound infection: a clinical and cost-effectiveness study. British Journal of Midwifery2014;22:23-7

4. Dryden M. Tawse C. Adams J. Saeed K. Cooke J. The use of Surgihoney to prevent or eradicate bacterial colonisation in dressing oncology long vascular lines. Journal of Wound Care2014;23:338-41.

5. Cooke J. When antibiotics can be avoided in skin inflammation and bacterial colonization: a review of topical treatments. Current Opinion in Infectious Diseases 2014;27:125-9.

6. Cooke J, Dryden M, Patton T, Brennan J, Barrett J. The antimicrobial activity of prototype modified honeys that generate reactive oxygen species (ROS) hydrogen peroxide. BMC Research Notes. 2015;8(1):20. Epub 2015/01/30. doi: 10.1186/s13104-014-0960-4. PubMed PMID: 25627827; PubMed Central PMCID: PMCPMC4312449.

7. Dryden M, Milward G, Saeed K. Infection prevention in wounds with Surgihoney. Journal of Hospital Infection 2014. Oct;88(2):121-2.doi:10.1016/j.jhin.2914.07.008.Epub 2014 Aug1

8. Halstead F, Oppenheim B, Dryden M. The in vitro antibacterial activity of engineered honey (Surgihoney®) against important biofilm-forming burn wound pathogens. Poster presentation. Federation of Infection Societies. Harrogate, 2014.

9. Staples, I. Why doesn't nectar ferment. Primary Care Nursing Review, March 2014.

10. Kanta J, The role of hydrogen peroxide and other reactive oxygen species in wound healing, Acta Medica 2011.

11 Fahmida Alam, Asiful Islam, Siew Hug Gan, Ibrahim Khalil. Honey: A potential therapeutic agent for managing diabetic wounds. Evidence-based Complementary and Alternative Medicine., Oct 2014

12. Dryden M. Engineered honey to manage bacterial bioburden and biofilm in chronic wounds - abstract of presentation to European Wound Management Association, May 2015.

13. Dunnill C, Patton T, Brennan J, et al. Reactive oxygen species (ROS) and wound healing: the functional role of ROS and emerging ROS-modulating technologies for augmentation of the healing process. International Wound Journal, Dec 2015!

14. Vatansever F1, de Melo WC, Avci P, Vecchio D, Sadasivam M, Gupta A, Chandran R, Karimi M, Parizotto NA, Yin R, Tegos GP, Hamblin MR. Antimicrobial strategies centred around Reactive Oxygen™ species--bactericidal antibiotics, photodynamic therapy, and beyond FEMS Microbiol Rev. 2013 Nov;37(6):955-89. doi: 10.1111/1574-6976.12026. Epub 2013 Jul 25.

15. Halstead F, Webber M, Rauf M, Burt R, Dryden M, Oppenheim B. In vitro activity of an engineered honey, standard medical-grade honeys and antimicrobial wound dressings against biofilm-producing clinical bacterial isolates. Journal of Wound Care, Feb 2016

16. Dryden M, Dickinson A, Brooks J, Hudgell L, Saeed K, Cutting K. A multi-centre clinical evaluation of Reactive OxygenTMtopical wound gel in 114 wounds. Journal of Wound Care, March 2016.

17. The Review on Antimicrobial Resistance, chaired by Jim O’ONeill, Vaccines and alternative approaches: reducing our dependence on antimicrobials, Feb 2016

18. Khan W, Williams R, Metal A, Morgan-Jones R. Surgihoney as a novel antimicrobial coating in salvage revision total knee arthroplasty. Orthopaedic Proceedings. 2015;97-Bmo.SUPP 15 66 ISSN 1358-992X

19. Dryden M, Cooke J, Salib R, Holding R, Pender S, Brooks J. Hot Topics in Reactive Oxygen therapy:antimicrobial and immunological mechanisms, safety and clinical applications. Journal Global Antimicorbial Resistance. 2017 Feb 17. pii:S2213-7165(17)30224-3doi:10.1016/j.gar.2016.12.012

20. Dryden M, Cooke J, Salib R, Holding R, Biggs T, Salamat A, Allan R, Newby R, Halstead F, Oppenhem B, Hall T, Cox S, Grover L, Al-Hindi Z, Noval-Frazer L, Richardson M. Reactive Oxygen: a novel antimicrobial mechanism for targeting biofilm-associated infection.Journal of Global Antimicrobial Resistance. 2017 Feb 14;8:186-191.doi 10.1016/j/jgar.2016.12.006

21.Dryden M. Reactive Oxygen therapy: a novel therapy is soft tissue infection.Current Opinion in Infectious Disease2017 Apr;30(2):143-149

22. Lipsky BA, Dryden M, Gottrup F, et al. Antimicrobialstewardship in wound care: a positionpaper from theBritish Society for Antimicrobial Chemotherapy and European WoundManagement AssociationJournal of Antimicrobial Chemotherapy2016,10.1093/jac/dkw287

23. Al-Waili N, Salom K, Al-Ghamdi AA. Honey for wound healing, ulcer and burns;data supporting itsuse in clinical practice. TheScientific World Journal2011:766-87

24. Ridley M. The Times. Ourbrilliant biologists are changing the world. Dec 19,2016

25.Khan W, Williams R, Metal A, Morgan-Jones R. Surgihoney as a novel antimicrobial coating in salvage revision total knee arthroplasty. Orthopaedic Proceedings. 2015;97-B no.SUPP 15 66.ISSN 1358-992X

26. Dryden M Reactive oxygen species treatment in the management of wounds. Wounds UK. vol 13, No 2 2017

27. Halstead F, Webber M, Oppenheim B. Use of an engineered honey to eradicate pre-formed biofilms of important wound pathogens: an in vitro study. Journal of Wound Care, 2017

28. Public Health England 'Management and Treatment of Common Infections Antibiotic Guidance For Primary Care,' 2017 and 2018.