Since the ancient civilizations of the Greeks, Romans, Egyptians, and Chinese, honey has been used to heal wounds, among other maladies. With the development of antibiotics, conventional western medicine has removed much of its focus from natural remedies. However, in recent studies honey has been shown to be quite effective at healing wounds, even outperforming conventional treatments in many cases!
Honey is antibacterial, anti-inflammatory, antioxidant, and promotes new tissue growth. [1,2,3,4] It’s physically unique from other treatments in that it has a high osmolarity that draws lymph fluid from the wound, cleaning the wound bed from underneath. [1,2,5] It also has a high viscosity that creates a physical barrier over the wound. [1,2,3] The extracted layer of lymph fluid prevents the wound from sticking to the bandage and further damaging it when the dressing is changed. These properties create the perfect environment for efficient healing of wounds, including cuts, scratches, burns, surgical wounds, many types of ulcers, and more. [1,2,5]
Honey & Bacteria
For a wound to heal quickly and properly, the first step is to keep it clean to prevent bad bacteria and infection. Honey has several characteristics that make it antimicrobial, meaning it prevents growth of bad bacteria. Its high osmolarity (high sugar, low water content) dehydrates bacteria and makes it near impossible to survive. [1,2,3,4] This effect is amplified by high acidity and phytochemicals that occur in honey, which by themselves have antibacterial properties. These phytochemicals include phenolic compounds, flavonoids, and organic acids that come from the nectar used to produce honey. When honey is diluted, the enzyme glucose oxidase creates small amounts of hydrogen peroxide, further sterilizing the area.
Studies have shown honey to kill and/or prevent growth of many bacteria, including some commonly known strains like Staphylococcus aureus (staph infection), Salmonella shigella (salmonella), Vibrio cholera (cholera), and enteropathogenic Escherichia coli (E. coli). [2,3,4,5] Wildflower honeys generally have higher antibacterial activity than specific varietals, with the exception of manuka honey. [1,2]
Honey & Inflammation
Inflammation is a natural part of the healing process, but excessive inflammation slows healing and potentially causes tissue damage and scarring. Abnormal amounts of fluid fill the tissue of inflamed areas, restricting blood flow. The oxygen and nutrients needed for efficient healing are unable to reach the wound. Honey’s high osmolarity comes into play again here. The high sugar content attracts liquid, drawing excess fluid from tissue and pulling oxygen and nutrients into the wound site. [1,4] The flavonoids, polyphenols, and organic acids in honey are also anti-inflammatory in various ways, such as suppressing enzymes associated with inflammation. [1,2,6]
Inflammation and oxidative stress go hand in hand, creating free radicals- unstable molecules that attack other cells. They impair proteins, nucleic acids, and lipids, resulting in tissue damage.  Honey is antioxidant, meaning it contains chemical compounds that help protect cells against free radicals. These compounds include flavonoids, phenolic compounds, tocopherols, ascorbic acid, and enzymes. 
Honey may be particularly helpful in healing burns and ulcers, both of which can cause high levels of inflammation. In the case of burns, honey has been shown to successfully prevent partial thickness burns from becoming full thickness burns that would have otherwise required plastic surgery. [1,2] In one study, a honey wound-dressing helped heal burns more rapidly than polyurethane film, paraffin gauze, soframycin-impregnated gauze, or sterile linen. 
Honey & Tissue Growth
Interestingly, honey not only creates an ideal environment for wound healing by preventing bacteria and inflammation; it actually stimulates tissue growth! Specifically, it stimulates production of epithelial and collagen, and angiogenesis. [1,2,3,4] Epithelium cells create the outer layer of skin, and collagen proteins strengthen tissue, decreasing the chances a wound surface will break as it heals. Angiogenesis is the construction of blood vessels, which then increases oxygen supply. The high acidity of honey also helps to release oxygen from hemoglobin. [1,2,4] Honey provides amino acids, vitamins, minerals, and sugars as well, all aiding in the healing process. While honey has been shown to initiate healing even in dormant wounds, it does not penetrate scabs well. 
Other Benefits & Studies
Honey is an immune system stimulant, activating white blood cells near the wound site. B- & T-lymphocytes, phagocytes, and monocytes all have specific functions in responding to infection. [1,4] Honey even deodorizes wounds! Odors in wounds usually occur from bacteria metabolizing amino acids. Bacteria prefers the sugars in honey, while the honey prevents future bacterial growth. 
Honey has also been shown to heal wounds not responding to antibiotics. It is effective on antibiotic-resistant bacteria and can be used freely, without fear of bacteria developing resistance. [1,2,3,4] Honey is generally considered safe to use on everyone; it’s nontoxic and a nonirritant, and there are no recorded negative effects! [1,3]
One study showed honey to heal wounds faster and with less infection than polyurethane film or silver sulfadiazine.  In another, honey inhibited nine types of pathogenic organisms from UTIs better than six antibiotics, five being synthetic and one natural.  A third study with one hundred burn patients revealed honey to heal faster and without the need for skin grafting compared to mafenide acetate. 
It is best to dress a wound with honey as soon as possible. Antibacterial activity will be most effective if it is localized; topical use of honey will not treat systemic infection.  The honey must be raw to preserve its beneficial enzymes and chemical compounds. Honey should completely cover the wound and any inflammation with a secondary dressing (like gauze) to hold it in place, and it should be changed frequently, as lymph fluids dilute it. 
Medical grade honey is recommended to ensure effectiveness. The antibacterial activity is tested, and any live spores are deactivated without damaging the honey. The honey is collected from areas that meet organic certification to prevent any contamination from pesticides or heavy metals. Manuka honey, produced in Australia and New Zealand from pollination of the manuka tree (Leptospermum scoparium), is most often used in medical honey. It contains unique compounds that make it more antibacterial than other varieties of honey, namely methylglyoxal and leptosperin. [2,4] Wildflower and buckwheat honey have also been used in some medical products, though manuka is far more common and consistent. 
Disclaimer: This blog is intended to be informational, not instructional. Remember we’re beekeepers, not doctors :) Please seek professional care for serious injury.
- Re-introducing Honey in the Management of Wounds and Ulcers – Theory and Practice
- Honey in Wound Healing
- Comparison between topical honey and mafenide acetate in treatment of burn wounds
- Role of Honey in Advanced Wound Care
- Honey- A Remedy Rediscovered
- Oxidative Stress and Inflammation: What Polyphenols Can Do for Us? - PMC