Use of Supplemented Medical-Grade Honey to Treat Traumatic Skin Injuries in Geriatric Patients in a Home-Care Setting – Papanikolaou G. E, Kegels P., Gousios G., Kegels F., Peters L., Cremers N. (2025)

Traumatic skin injuries (TSI) are more common to geriatric population due to reduced skin elasticity and increased gait instability. This is also associated with an altered wound-healing mechanism thus requires a cost-efficient and effective treatment. Therefore, the aim of the present study is to highlight the efficacy of medical-grade honey (MGH) supplemented with vitamins C and E for the conservative treatment of TSI in a home-care setting. The present multicenter retrospective case series study included 10 geriatric patients (four men and six women) who sustained TSI of various etiologies. The median age of the patients was 82.5 years (min-max: 65-90 years). Cardiovascular disease was the most frequent concomitant illness (50% of the patients). Previous treatments with povidone-iodine, alginate gel, or simple gauze for 5.5 days (median, min-max: 0-21 days) were ineffective. Treatment with a variety of supplemented MGH products, including ointment, wound gel, gauze, and foam, was commenced upon the initial patients’ examination. By using MGH products, we achieved effective reduction of the inflammation, removal of the necrotic tissue, and formation of healthy granulation and epithelial tissue. MGH eliminated clinical signs of infection after 7.5 days (median, min-max: 5-35 days). Wounds were completely healed after 21 days (median, min-max: 14-56 days), without evidence of recurrence or complications, and with good functional and aesthetic outcomes. Supplemented MGH-based products present high clinical efficacy for the treatment of TSI in older adults in a home-care setting, while demonstrating a safe and easy-to-use profile. Therefore, they can be proposed as an alternative or complementary therapeutic approach to conventional TSI therapies.

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The prevalence of bacterial vaginosis (BV) among women of reproductive age is 29%. BV arises from a vaginal imbalance marked by reduced levels of lactic acid-producing lactobacilli and an overgrowth of pathogenic anaerobes. The multifactorial nature of BV’s pathogenesis complicates its treatment. Current antibiotic therapy exhibits a recurrence rate of about 60% within a year. Recurrence can be caused by antibiotic treatment failure (e.g., due to antimicrobial resistance), the persistence of residual infections (e.g., due to biofilm formation), and re-infection. Because of the high recurrence rates, alternative therapies are required. Medical-grade honey (MGH), known for its antimicrobial and wound healing properties in wound care, emerges as a potential novel therapy for BV. MGH exerts broad-spectrum antimicrobial activity, employing multiple mechanisms to eliminate the risk of resistance. For example, the low pH of MGH and the production of hydrogen peroxide benefit the microbiota and helps restore the natural vaginal balance. This is supported by in vitro studies demonstrating that MGH has an antibacterial effect on several pathogenic bacteria involved in the pathophysiology of BV, while lactobacilli and the vaginal microenvironment can be positively affected. In contrast to antibiotics, MGH exerts anti-biofilm activity, affects the microbiome as pre- and probiotic, and modulates the vaginal microenvironment through its anti-inflammatory, anti-oxidative, physicochemical, and immunomodulatory properties. 

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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.

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Minor burns and scalds are common, painful injuries among children. In this evaluation, the author sought to establish if L-Mesitran® dressings (Aspen Medical Europe Ltd) – a range of honey enriched advanced wound dressings – provided positive patient experiences and outcomes in the management of minor burns and scalds in a paediatric population. L-Mesitran Hydro and Border were found to reduce erythema and pain. Feedback from clinicians, parents, and children was positive overall.

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Chronic leg ulcers are a common medical problem among elderly patients and have a dramatic impact on quality of life as a result of pain, disability, and social isolation. Regardless of their cause, chronic leg ulcers remain difficult to treat. In recent years, there has been increasing interest in the use of honey as a therapeutic agent. Objective: To evaluate the efficacy of honeybased dressings in the treatment of chronic leg ulcers. Methods: Ten patients with chronic (mean duration 3.3 years) leg ulcers who had received non-honey based treatments with no improvement were included in this study. A honey gel dressing was applied twice a week as the only treatment. Results: Seven patients experienced complete healing of their leg ulcers. The remaining three patients showed a significant reduction in wound size, which was achieved in a mean time of 101 days (range 28-174 days). Conclusion: Honey-based dressings appear to be an efficient and easy-to-use treatment for leg ulcers.

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To demonstrate that L-Mesitran honey exhibits antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Klebsiella pneumoniae, two experiments will be conducted. Additionally, the antimicrobial activity of the honey products will be compared to that of the silver product.

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The overall reported percentage of mesh infections is 1.3%. Infections after incisional ventral hernia repair depend on many factors. Salvaging an infected mesh should be the priority, because serious complications are reported following mesh removal. In this case report, a methicillin-resistant Staphylococcus aureus (MRSA)-infected titanium mesh was salvaged by a novel technique, not requiring removal. The combination of vacuum-assisted closure (VAC™ therapy) of the wound and medical honey (L-Mesitran™) proved to be successful in leaving the mesh in situ. We report the successful management of this infected titanium mesh and review the literature regarding the possible pathogenetic mechanisms and treatment options

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This article outlines the key actions of honey when used as a treatment for wounds and examines the evidence base for its efficacy and impact on clinical outcomes. It also provides a guide to the assessment of wounds in order to identify infection, to ensure that antimicrobial dressings such as honey are used appropriately. Finally, the Mesitran range of dressings (Aspen, Redditch) is described and individual case reports presented which demonstrate the use of these products in clinical practice.

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To establish whether honey and silver-impregnated dressings used by wound-healing practitioners are cytotoxic in vitro to human skin keratinocytes and dermal fibroblasts. Human keratinocyte and fibroblast tissue cultures were established in vitro. Untreated cultures served as controls (group I). Small dressing implants of monofloral, medicinal honey (L-Mesitran) (group 2) and nanocrystalline silver (Acticoat) (group 3) were placed in test wells and co-cultured with each of the two cell lines. Morphological changes, including cell toxicity, were assessed using inverted microscopy, trypan blue staining and the Rosdy and Clauss cell toxicity scoring system. Untreated cultures consisting of both keratinocytes and fibroblasts (group 1) were established in 90% of all cases. In group 2, cultures with honey-impregnated implants, cell proliferation remained present at two and four months. Cell viability remained intact and cell toxicity was not evident at four months after continuous tissue culture. In group 3, marked toxicity was observed with high non-viability staining and cell-scoring counts compared with groups 1 and 2 (p<0.05). This demonstrates that the silver interfered with epidermal cell proliferation and migration, implying that it contains cytotoxic material. The honey-based product showed excellent cytocompatibility with tissue cell cultures compared with the silver dressing, which demonstrated consistent culture and cell toxicity. Further studies are needed to assess if these comparative in-vitro findings should influence a clinician’s choice of wound dressing.

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This paper reviews the current knowledge about the use of honey in the treatment of skin wounds. Most experience has been gained in human medicine, but first reports of its use in animals are available. Honey has, after application to wounds, an antibacterial effect against several bacteria and shows reduced oedema and discharge. Moreover, it helps in generating granulation and epithelial tissue and has an odour neutralizing effect. The need to use sterilized honey products free from pesticide and antibiotic residues is explained.

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