Biofilms hinder wound healing. Medical-grade honey (MGH) is a promising therapy because of its broad-spectrum antimicrobial activity and the lack of risk for resistance. This study investigated the inhibitory and eradicative activity against multidrug-resistant Pseudomonas aeruginosa biofilms by different established MGH-based wound care formulations. Six different natural wound care products (Medihoney, Revamil, Mebo, Melladerm, L-Mesitran Ointment, and L-Mesitran Soft) were tested in vitro. Most of them contain MGH only, whereas some were supplemented. L-Mesitran Soft demonstrated the most potent antimicrobial activity (6.08-log inhibition and 3.18-log eradication). Other formulations ranged between 0.89-log and 4.80-log inhibition and 0.65-log and 1.66-log eradication. Therefore, the contribution of different ingredients of L-Mesitran Soft was investigated in more detail. The activity of the same batch of raw MGH (1.38-log inhibition and 2.35-log eradication), vitamins C and E (0.95-log inhibition and 0.94-log eradication), and all ingredients except MGH (1.69-log inhibition and 0.75-log eradication) clearly support a synergistic activity of components within the L-Mesitran Soft formulation. Several presented clinical cases illustrate its clinical antimicrobial efficacy against Pseudomonas aeruginosa biofilms. In conclusion, MGH is a potent treatment for Pseudomonas biofilms. L-Mesitran Soft has the strongest antimicrobial activity, which is likely due to the synergistic activity mediated by its supplements.
Background/Objectives: Foam dressings are designed for their ability to manage exudate and are selected to optimize wound repair. Various foam dressings are available, ranging from basic polyurethane to more sophisticated options, incorporating active components to combat infections or foster healing. This study investigates the requirements for the most suitable foam dressing through a combination of field research, laboratory testing, and clinical evaluation. Methods: We tested 17 foam dressings commonly used by wound care professionals while attending an international conference. An effective foam dressing should absorb wound fluid for several days, as wound care professionals value absorption and retention capacity, often favoring less frequent changing dressings, preferably twice a week or even weekly. Results: The foam dressings tested can absorb the expected amount of exudate typically produced by different wound types. There is some variability in retention capacity and product prices, resulting in differences in cost-effectiveness among products. In addition, some dressings are enriched with active ingredients that can accelerate healing through their antimicrobial and anti-inflammatory properties, such as foam dressings infused with silver or honey. A honey-based foam dressing was evaluated in a clinical survey involving eight wound care specialists, and four clinical cases with varying wound pathologies were discussed in more detail to highlight its key properties. Conclusions: Ideally, a foam dressing should have adequate absorption and retention capacities, effectively resolve and prevent infections, protect against external trauma, ensure optimal patient comfort without damaging newly formed granulation tissue, accelerate wound healing processes, and reduce wound care time (e.g., remaining in place for 7 days). Together, these factors make honey- or silver-loaded foam dressings more cost-effective than plain dressings due to their antimicrobial activities and ability to nourish tissues.