TITLE:
Comparative Evaluation of Povidone-Iodine and Honey Dressings in the Management Outcomes of Cervicofacial Necrotizing Fasciitis
AUTHORS:
Kesiena Seun Yarhere, Achemoche Paul Saiki, Aimuamwosa Dennis Osagie, Tochukwu Malachy Odo, Efetobo Victor Orikpete
KEYWORDS:
Cervicofacial Necrotizing Fasciitis, Honey, Wound Dressing, Povidone-Iodine, Necrotizing Soft Tissue Infection
JOURNAL NAME:
Journal of Biosciences and Medicines,
Vol.14 No.4,
April
15,
2026
ABSTRACT: Background: Cervicofacial necrotizing fasciitis (CNF) is a rapidly progressive, life-threatening soft tissue infection requiring prompt surgical and medical management. Following surgical debridement, wound care plays an important role in infection control and tissue healing. In resource-limited settings, commonly used dressing materials include povidone-iodine and honey. However, comparative evidence regarding their effectiveness in the management of CNF remains limited. Objective: This study aimed to compare the effect of honey and povidone-iodine wound dressings on the duration of hospital stay and mortality outcomes in patients treated for cervicofacial necrotizing fasciitis. Methods: A retrospective comparative cohort study was conducted at the Department of Oral and Maxillofacial Surgery, University of Port Harcourt Teaching Hospital, Nigeria. Records of patients managed for cervicofacial necrotizing fasciitis between January 2020 and December 2025 were reviewed. Eligible cases included patients who underwent surgical debridement and received postoperative wound dressing with either honey or povidone-iodine. Data collected included demographic characteristics, defect size, comorbidities, complications, microbiological findings, duration of hospital stay, and treatment outcome. Statistical analysis was performed using SPSS version 26. Continuous variables were assessed for normality using the Shapiro-Wilk test. The Mann-Whitney U test was used to compare hospital stay between groups. Multiple linear regression was used to evaluate predictors of hospital stay, while binary logistic regression was used to assess predictors of mortality. Statistical significance was set at p Results: Thirty patients met the inclusion criteria, comprising 18 (60.0%) managed with honey dressings and 12 (40.0%) treated with povidone-iodine. The overall mean age was 61.4 ± 17.9 years, and 56.7% were male. The median duration of hospital stay was shorter among patients treated with honey (8 days) compared with those treated with povidone-iodine (13 days); however, this difference was not statistically significant (p = 0.329). In multiple linear regression analysis, wound dressing material did not independently predict hospital stay (p = 0.523). The overall mortality rate was 26.7%, with slightly higher mortality in the povidone-iodine group (33.3%) compared with the honey group (22.2%). Logistic regression analysis showed that the occurrence of complications was the only significant predictor of mortality (OR = 10.03; 95% CI: 1.51 - 66.68; p = 0.017), whereas the type of dressing material was not significantly associated with survival outcomes. Conclusion: Although honey dressings demonstrated slightly shorter hospital stay and lower mortality compared with povidone-iodine, these differences were not statistically significant. Clinical outcomes in cervicofacial necrotizing fasciitis appear to be influenced primarily by the occurrence of complications rather than the choice of dressing material.