• Bouke K H L Boekema, Daniela Chrysostomou, Guido Ciprandi, Anouk Elgersma, Marcel Vlig, Andrea Pokorná, Linsey J F Peters, and Niels A J Cremers.
• Preclinical Research, Association of Dutch Burn Centers (ADBC), P.O. Box 1015, 1940 AE Beverwijk, the Netherlands; Plastic, Reconstructive and Hand Surgery, AUMC, Amsterdam, the Netherlands.
• Burns. 2024 Apr 1; 50 (3): 597610597-610.

AbstractBurns 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.Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

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