Comparing the antibacterial and healing properties of medical-grade honey and silver-based wound care products in burns

BOEKEMA, Bouke K H L, Daniela CHRYSOSTOMOU, Guido CIPRANDI, Anouk ELGERSMA, Marcel VLIG, Andrea POKORNÁ, Linsey J F PETERS and Niels A J CREMERS. Comparing the antibacterial and healing properties of medical-grade honey and silver-based wound care products in burns. Burns. London: ELSEVIER, 2024. ISSN 0305-4179. Available from: https://dx.doi.org/10.1016/j.burns.2023.10.009.

Basic information

• Original name: Comparing the antibacterial and healing properties of medical-grade honey and silver-based wound care products in burns
• Authors: BOEKEMA, Bouke K H L, Daniela CHRYSOSTOMOU, Guido CIPRANDI, Anouk ELGERSMA, Marcel VLIG, Andrea POKORNÁ, Linsey J F PETERS and Niels A J CREMERS.
• Edition: Burns, London, ELSEVIER, 2024, 0305-4179.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Country of publisher: United Kingdom of Great Britain and Northern Ireland
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 2.700 in 2022
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1016/j.burns.2023.10.009
• UT WoS: 999
• Keywords in English: Medical-grade honey; Pseudomonas aeruginosa; Silver sulphadiazine; Silver nitrate; Infected burn wounds; Wound healing
• Tags: 14110525, 14110611
• Tags: International impact, Reviewed

Abstract

Burns are a major global healthcare concern, often complicated by the presence of bacteria such as Pseudomonas aeruginosa in the wounds. Silver-based dressings are commonly used in the treatment of burns but can cause skin irritation and delay healing time. Medical-grade honey (MGH) provides an interesting alternative. This study investigated the antimicrobial effects and possible cytotoxicity of L-Mesitran Soft (MGH-gel) and its individual components, Medihoney (Manuka), Flammazine (silver sulphadiazine), and silver nitrate (AgNO3) in an ex vivo human burn wound model. Bacterial survival and wound healing parameters, including re-epithelialization and keratinocyte proliferation were assessed. L-Mesitran, Flammazine, and AgNO3 reduced P. aeruginosa numbers below detection levels. L-Mesitran Soft exhibited a significantly stronger antimicrobial effect compared to Medihoney. The individual components of L-Mesitran contributed significantly to its antibacterial efficacy, thus suggesting synergistic activities. Moreover, L-Mesitran, Flammazine, and AgNO3 slightly inhibited re-epithelialization while Medihoney treatment resulted in a complete lack of re-epithelialization and keratinocyte proliferation. Furthermore, clinical cases illustrated the effectiveness of MGH therapy in infected burns. Overall, L-Mesitran Soft had similar effects as silver-based products on bacterial load and epidermal regeneration, but outperformed Medihoney. Therefore, supplemented MGH could be used as an effective alternative to silver-based dressings for P. aeruginosa-infected burns.