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SurgihoneyROTM 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 (SurgihoneyROTM ) as a treatment for venous leg ulcers to reduce bacterial load and infection, explaining it could help reduce antibiotic use. (28 )

SurgihoneyROTM (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)

SurgihoneyROTM 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, SurgihoneyROTM was 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 SurgihoneyRO™ compared to other antimicrobial agents

Hydrocolloid / Alginate products Silver dressings Antispectics (e.g. iodine, chlorhexidine) SurgihoneyRO™
Safe (non-toxic)
Promotes wound healing at a cellular level
Wound barrier
Moisture control
De-sloughing agent
Local wound nutrition
Odour control
Pain Suppressant



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 SurgihoneyROTM can 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. SurgihoneyROTM is comparable to silver-impregnated dressings in antimicrobial activity but without the toxic side-effects.(1, 15)

Read the paper here





Clinical Evidence

Reactive Oxygen® Made Easy

Reactive Oxygen® Made Easy

Dryden, M. and Stephens, C., Wounds UK, 2018, 14 (5)

A multi-centre clinical evaluation of SurgihoneyRO™ in 114 wounds

Dryden, M., Dickinson, Brooks, J., A., Hudgell, L., Saeed, K. and Cutting, K.F., Journal of Wound Care, 2016, 25 (3)

A multi-centre clinical evaluation of SurgihoneyRO™ in 114 wounds

Using antimicrobial SurgihoneyRO™ to prevent caesarean wound infection

Dryden, M., Goddard, C., Madadi, A., et al., British Journal of Midwifery, 2014, 22 (1)

Using antimicrobial SurgihoneyRO™ to prevent caesarean wound infection

A topical antimicrobial wound gel to treat multi-drug resistant pathogens in wound care

Thomas, H., Davies, L. and Westgate, S.J., Poster, Perfectus biomed, 2018

A topical antimicrobial wound gel to treat multi-drug resistant pathogens in wound care
Treatment of World Health Organisation priority pathogens using an antimicrobial wound gel

Treatment of World Health Organisation priority pathogens using an antimicrobial wound gel

Thomas, H., Davies, L. and Westgate, S.J., Poster, Perfectus biomed, 2018

Bioengineered honey: in vitro antimicrobial activity of a novel topical wound care treatment

Dryden, M., Journal of Global Antimicrobial Resistance & Journal of Antimicrobial Chemotherapy, 2014

Bioengineered honey: in vitro antimicrobial activity of a novel topical wound care treatment

How to apply

SurgihoneyRO™ is applied directly to the wound bed or surgical incision site

To ensure optimum results please follow the following guidelines:

  • Cleanse the wound as per local guidelines
  • Apply 2mm thickness directly to the wound bed. Alternatively, SurgihoneyRO™ can be applied to an inert wound contact or secondary dressing then placed on the wound bed
  • Select an appropriate secondary dressing for exudate level and to maintain moist wound healing environment
  • A tube of SurgihoneyRO™ may be used on a single patient, multiple times, for up to 28 days

It is recommended that SurgihoneyRO™ is applied every 72 hours (3 days) and more frequently in critical wound infections to maximise effect.

  • For critically infected wounds, it is recommended that SurgihoneyRO™ is applied daily then reduce to alternate days, then to every 3 days over the first 2 weeks (subject to individual clinical scenario). If there is no improvement in the wound condition and microbial status use should be reviewed
  • For surgical incision sites, it is recommended to apply SurgihoneyRO™ once immediately after closure to assist healing and as a secondary infection prevention measure

SurgihoneyRO™ may be used under compression bandaging for up to 7 days however potency will decrease after day 3.

With a low therapeutic dose of H202 there are no contraindications associated with long term use and it is non-toxic to healthy tissue. It may be used on children.

Indications for use

SurgihoneyRO™ is indicated for infected, chronic and acute wounds through to wound healing

Chronic wounds including:-

  • Diabetic foot ulcers
  • Pressure ulcers
  • Leg ulcers

Infected wounds

Acute wounds including:-

  • Surgical wounds
  • Traumatic wounds, cuts and abrasions
  • Burns
  • Donor and recipient sites

SurgihoneyRO™ is a safe and effective multi-action product without the drawbacks of other antimicrobial wound dressings. The bioengineering ensures a consistent level of therapeutically active Reactive Oxygen® which aids the antimicrobial activity for up to 3 days.

Why is it different?

When SurgihoneyRO™ comes into contact with moisture, Reactive Oxygen® is instantly released and sustained for over 72 hours1

Medical-grade honey is an established topical treatment for wounds and burns due to its antimicrobial and wound healing promotion activity. It provides rapid autolytic debridement, reduces odour and decreases wound-related pain and bio-burden2. Honey works in a different way to antibiotics – it is hypersomolar, restricting the availability of water to bacteria and dehydrating bacteria by osmosis.

Natural honeys vary hugely in their antimicrobial properties and there is little consistency in antimicrobial effects because there can be no control over nectar source, sugar content and other contaminants in entirely natural products. Many medicinal honeys are based on Manuka honey, which is one of the more antimicrobial natural honeys.

Different mechanisms of action have been suggested for the antimicrobial effects of honey, but the main ones are the high-sugar concentration, H2O2, the 1,2-dicarbonyl compound methylglyoxal (MGO), the cationic antimicrobial peptide bee defensin-1 and the low pH3. Some patients may experience momentary stinging or a drawing sensation when using honey therapies due to its autolytic debriding properties and the drawing of fluids by osmosis away from the wound4.

SurgihoneyRO™ has all the natural healing-inducing, desloughing and tissue regenerative properties of the honey carrier, but it has been bioengineered to deliver precisely controlled level of Reactive Oxygen®.

SurgihoneyROTM is a fast acting, effective antimicrobial.

SurgihoneyRO™ not only inhibits but also kills microbes at concentrations 10-1000 fold below those that are likely to be achieved in topical treatment. The speed of cidal activity is shown by the time-kill curves to be extremely rapid.4.


Reactive Oxygen®

SurgihoneyRO™ is the first published, antimicrobial wound dressing that has been tested against the 12 priority MDR bacterial strains, and has been shown to be effective against almost all these organisms1

The term reactive oxygen species (ROS) describes highly reactive molecules containing reduced oxygen or oxygen atoms with extra electrons. Members of the ROS family include superoxide anion O2, peroxide O22, hydrogen peroxide H2O2.

ROS are naturally occurring in the body. Basal ROS levels maintain normal cell functioning and homeostasis2, while increased amounts induce a cell-mediated antimicrobial defence response3.

ROS are part of the innate immune response, and play a critical role in wound healing and infection control at the wound site4. They are released within minutes of epithelial injury, signalling rapid recruitment of leukocytes5. ROS directly damage microbes that invade tissues6. In wound healing, ROS are secondary messengers to many immunocytes and non-lymphoid cells, and regulate angiogenesis, haemostasis and tissue repair7.

Reactive Oxygen® is the antimicrobial mechanism for SurgihoneyRO™. In contact with moisture, SurgihoneyRO™ releases Reactive Oxygen®.

In vitro studies have shown that Reactive Oxygen® at close to naturally occurring levels:

  • Stimulates proliferation of human fibroblasts and vascular endothelial cells5,13
  • Stimulates angiogenesis via vascular endothelial growth factor (VEGF) signalling14
  • Promotes keratinocyte cell migration and proliferation15

A controlled and sustained level of H2O2 that is non-harmful and non-toxic to surrounding tissue, is a therapeutic opportunity for wound care. SurgihoneyRO™ does this through the release of Reactive Oxygen®. To find out more on the technology of SurgihoneyRO™ and Reactive Oxygen®, read the Reactive Oxygen Made Easy.

Scientists from the National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre, the research arm of the NHS, demonstrated SurgihoneyRO™ is highly effective at tackling a wide variety of bacterial biofilm found in chronic wounds in vitro.

“Given the threat posed by antimicrobial resistance and the ever-increasing need to find new solutions to treat infections, SurgihoneyRO™ has real potential as a new wound care agent to kill bacteria and disrupt biofilm.” – Fenella Halstead, Clinical scientist, National Institute for Health Research (NIHR) Surgical Reconstruction and Microbiology Research Centre.

SurgihoneyRO™ has been successfully used for infection prevention, eradication of MDR bacterial strains and prevention of surgical site infections and intravascular line care in vivo15,16,17.

The Reactive Oxygen® released by SurgihoneyRO™ is a broad-spectrum antimicrobial against wound-relevant MDR bacterial strains and has been shown to prevent and disrupt and eradicate mature biofilm.

SurgihoneyRO™ presents one option against the growing global issue of antimicrobial resistance.



What is SurgihoneyRO™?

SurgihoneyRO™ is a cutting-edge technology, an antimicrobial wound gel utilising bioengineered honey to deliver Reactive Oxygen® (RO™)

SurgihoneyRO™ provides enhanced healing and a powerful antimicrobial action to reduce the microbial load thus removing the barriers to wound healing. Unlike other medical grade honeys, SurgihoneyRO™ has been bioengineered to enhance and precisely control its antimicrobial potency.

  • Kills a wide range of bacteria in vitro1,2,3
  • Prevents biofilm in vitro1
  • Fast acting antimicrobial action2
  • Substantially eradicates mature biofilm in vitro4,5
  • Effective against multi drug-resistant microorganisms commonly found in chronic wounds6
  • Effective debridement
  • Assists the natural wound healing environment and promotes new tissue growth

SurgihoneyRO™ is the only published, proven antimicrobial wound dressing tested against the WHO priority pathogens6.