Honey accelerated Achilles tendon healing in critical-sized segmental defects in rabbits

Background The management of massive tendon injuries still has concerns. The purpose of this study was to examine the effectiveness of honey in the healing and regeneration of critical-sized Achilles tendon injuries in rabbits. Methods Twenty healthy male white albino rabbits were divided into untreated and honey-treated groups. A two-centimeter gap was made in the left Achilles tendon of each rabbit, and the defects were either left untreated (the untreated group) or treated with Ziziphus honey (the honey-treated group), after which they were sutured via a modified Kessler suture technique. The rabbits were euthanized on the 60th day post-injury, and the tendons were investigated for gross morphology, histomorphometry, transmission and scanning electron microscopy, dry matter content, and biomechanics. Results Newly regenerated tendons formed in the honey-treated group, whereas they were not visible in the tendons of the untreated group. Treatment with honey markedly increased tissue alignment, the density of collagen fibrils, fiber formation and maturation, and dry matter content. Honey also enhances the ability of tendons to bear weight. Compared with those of the untreated group, the histological, biomechanical, and ultrastructural characteristics of the newly formed tendons were considerably improved in the treated animals on the 60th day post-injury ( p < 0.05 ). Conclusion On the basis of the findings of this study, honey is a biodegradable and biocompatible material that can improve and accelerate the regeneration and healing of large and critical-sized Achilles tendon injuries. The outcomes of this in vivo preclinical study are hoped to be applicable in human clinical practice.