Beehive-Derived Products for Wound Management with a Focus on Diabetic Wounds: Mechanistic Insights, Advanced Delivery Strategies, and Translational Evidence

Wound healing is a complex biological process that can be severely impaired by persistent inflammation, oxidative stress, microbial infection, impaired angiogenesis, and defective extracellular matrix remodelling. These abnormalities are particularly prominent in diabetic wounds but also contribute to delayed healing in burn, venous, pressure, traumatic, and post-surgical wounds. Beehive-derived products, including honey, propolis, royal jelly, beeswax, and bee venom, have attracted considerable interest as multifunctional natural therapeutics because of their diverse antimicrobial, antioxidant, anti-inflammatory, immunomodulatory, and regenerative activities. Honey supports wound repair through its acidic pH, high osmolarity, hydrogen peroxide generation, and bioactive phytochemicals, whereas propolis provides flavonoids and phenolic compounds that contribute to antimicrobial, antioxidant, and tissue-regenerative effects. Royal jelly promotes cellular proliferation, angiogenesis, and tissue repair, while beeswax primarily provides moisture retention, barrier protection, and structural properties in wound dressings. Bee venom and its major component, melittin, exhibit antimicrobial, anti-inflammatory, and regenerative effects, although dose-dependent toxicity and hypersensitivity remain important concerns. Recent advances in hydrogels, polymeric films, electrospun nanofibres, nanoparticles, and composite scaffolds have improved the stability, local retention, controlled release, and therapeutic performance of these products. Preclinical studies demonstrate enhanced antimicrobial activity, fibroblast migration, collagen deposition, angiogenesis, and wound closure, while emerging clinical evidence supports their potential across several wound types. However, variability in composition, standardisation, safety, formulation stability, and limited large-scale clinical evidence remain major challenges.