INTRODUCTION: Honey has been proven to be efficacious in wound healing since ancient times. In the modern world, the application of honey has reappeared with a focus on the treatment of diabetic wounds.

METHODS: Thus, in the present study, an in situ hydrogel was fabricated through the use of a stimuli-responsive polymer, poloxamer 407, and chitosan. Each polymer was dispersed individually using the cold method. Subsequently, medical-grade honey was incorporated into the in situ hydrogel formulation, where the temperature at the site of application stimulated the conversion of the formulation from a sol form into a gel. An initial characterization of the formulation's spray diameter, gel-to-sol conversion, rheological parameters, and mucoadhesive characteristics has been performed. The anti-microbial activity, anti-oxidant activity, and in vivo wound healing efficacy of the formulation were also studied.

RESULTS: The selected in situ formulation demonstrated a phase transition at 33°C, a pH of 5.8, which is appropriate for use in wounds, and an appropriate viscosity (408 cP) that would allow the hydrogel to be applied easily. However, its strong mucoadhesive force (20.300 ± 0.557 g) would prevent the formulation from leaking after its application. Furthermore, the antibacterial efficacy of the formulation was also found to be satisfactory against both Escherichia coli (gram -ve) and Staphylococcus aureus (gram +ve). The excision wound model showed that the treatment group exhibited rapid re-epithelization and collagen formation in comparison to the control group and the standard group. The biochemical anti-oxidant assay showed that there were significant results in the treatment group compared to the control group.

CONCLUSIONS: Based on these findings, it could be concluded that using this in situ hydrogel of honey is a better option for treating diabetic wounds.