Purpose

To report the successful use of Indonesian local honey facilitating wound bed preparation prior to secondary reconstruction in a severe contaminated periocular degloving injury.

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Methods

A 33-year-old male motorcyclist sustained severe contaminated periocular degloving with extensive full-thickness eyelid lacerations, soft tissue avulsion, and heavy foreign material contamination. Multidisciplinary surgical debridement and tension-free layered anatomical reconstruction were performed on day 8, followed by Indonesian local honey-soaked gauze dressings applied to all residual wound sites with changes every two to three days.

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Results

Early epithelialization and wound closure were observed by postoperative day 8. By day 14, near-complete re-epithelialization was documented with stable eyelid alignment and best-corrected visual acuity of 20/30. Residual granulation tissue of 5×3 cm in the temporal region was covered with a full-thickness skin graft on day 55. At two-month follow-up, stable eyelid alignment, voluntary eyelid movement, and intact corneal surface without keratopathy were maintained, with no adverse effects attributable to honey dressing.

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Conclusion

Premature grafting over an inadequately prepared contaminated wound bed carries significant risk of reconstruction failure. A staged approach — optimizing the wound bed through Indonesian local honey dressing before definitive reconstruction — proved decisive. Indonesian local honey facilitated healing through high osmolarity inhibiting bacterial growth, hydrogen peroxide release providing broad-spectrum antimicrobial activity, low pH enhancing fibroblast activity, and modulation of inflammatory mediators promoting granulation and re-epithelialization, effectively converting a heavily infected wound into a well-granulated bed suitable for grafting. Comparable in efficacy to Manuka honey yet more accessible and cost-effective, Indonesian local honey represents an effective bridge to secondary reconstruction in severely contaminated periocular degloving injuries.

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Additional Authors

First name	Last name	Base Hospital / Institution
Nadya	Eunice	Department of Ophthalmology Faculty of Medicine, Hasanuddin University, Indonesia
Yunita	Mansyur	Wahidin Sudirohusodo Hospital, Makassar, Indonesia / Department of Ophthalmology Faculty of Medicine, Hasanuddin University, Indonesia
Sachraswaty R	Laidding	Wahidin Sudirohusodo Hospital, Makassar, Indonesia / Department of Plastic Reconstructive and Aesthetic Surgery Faculty of Medicine, Hasanuddin University

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