Bioactive Wound Care Reintroducing Silver and Honey

Syamala AriyanchiraBy Syamala Ariyanchira

March 14, 2017


Silver and honey are returning to heal wounds in their new avatars as bioactive wound care products.

The demand for bioactive wound care segment is on the rise globally. It is a key segment driving advanced wound care markets and is expected to grow in double-digit CAGR.

Chronic wounds such as diabetic foot ulcers, pressure ulcers, venous ulcers and acute burn injuries cannot be treated with normal wound healing solutions. In such advanced cases, bioactive wound dressings are being perceived more effective for controlling microbial infections and promoting steady healing.

Additionally, bioactive wound dressings also lessen wound odor, leakage, and pain.

Bioactive wound care dressings are broadly categorized into:

• Antimicrobials

Silver dressings and sustained release iodine dressings fall under this category. Honey is also being exploited for its antimicrobial properties and high viscosity, which serves as a protective barrier against the onset of infection.

• Interactive dressings

The dressings that use alginates, collagen and hydrocolloids help maintain a moist wound environment and interact with the matrix proteins in wounds to support quick healing. They include biodegradable dressings designed from seaweed, and which are used in the treatment of exudating wounds such as leg ulcers, infected surgical wounds, and pressure sores.

This article is looking exclusively into how silver and honey have captured the attention of advanced wound care product developers once again.

Market predictions

Globally, the demand for silver dressings is an important factor driving the growth of the global bioactive wound care market, which is estimated to grow at a CAGR of 5.6% and become a 5 billion dollar market by 2020. The market, as such, is still in its early stages, though. To make the most of the opportunities and to compete on par with the traditional wound care market, clinical trials and more robust marketing will be necessary to increase market acceptance and therefore sales.

The interest in honey and silver-based bioactive dressings is evident in emerging markets as well. Most of these markets are slowly adapting advanced wound care products, but the markets are expected to grow fast.

For instance, according to a recent study by AcuBiz Consulting, advanced wound care market in Malaysia is forecasted to grow at a CAGR of 11.5% between 2016-2021. In 2016, silver and honey products didn’t contribute much in Malaysia, but greater acceptance of these dressings is expected to boost future sales growth.

Here’s a look at a few commercialized silver and honey-based dressings that are supported by trials and being steadily adopted by healthcare providers.

Silver dressings

The earliest known use of silver for wound treatment was in sulphadiazine cream (SDC) for burns. However, the cream wasn’t effective enough and was discontinued. That didn’t affect the way silver was viewed as a potential antimicrobial, bioactive wound dressing, though.

Today, silver dressings are being manufactured by leading players such as 3M Healthcare, Smith & Nephew, and ConvaTec to treat acute and chronic wounds across North America and Europe.

ACTISORB® Activated Charcoal Dressing of Silver is the first commercialized silver dressing. First launched in 1980, this product is still in use. Its efficacy in absorbing and inactivating bacteria is supported by clinical trials. PROMOGRAN PRISMA™ Balancing Matrix Dressing is another advanced topical treatment for chronic (static and hard-to-heal) wounds containing silver, also backed by clinical evidence.

Anticoat uses silver-coating technologies in dressings to prevent wound adhesion and create an antimicrobial barrier against 150 pathogens. Clinical trials on Anticoat indicate its effectiveness in reducing pain, controlling the frequency of burn wound sepsis and the onset of secondary bacteremia. Controlled studies have indicated that Allevyn, another silver-based wound dressing, performs better than Anticoat on certain parameters. All these commercial silver dressings are expected to receive a shot in the arm in the future.

Silver is also an ingredient in innovative dressings entering the market. A recent example is Advanced Microcurrent Technology® (AMT) platform from Vomaris, comprising of embedded micro cell batteries with elemental silver and zinc, which generate microcurrents on the dressing surface to minimize microbial growth within the dressing.

Honey based dressings

Honey’s use as a biological dressing dates back thousands of years and is a traditional knowledge in many indigenous populations. Recently, clinical trials results have also been supporting its efficacy in healing chronic and acute wounds. The following key points help us understand the role of honey in this application:

  • Being acidic, with a pH of 3.2-4.5, honey’s topical acidification of wounds releases oxygen from hemoglobin to promote healing
  • The risk of bacterial resistance to honey is low in so far as high concentrations of honey are maintained clinically

Manuka honey is the first honey-based FDA-approved medical product for wound and burns dressings. It can be easily bought online and in medical supply stores.

Derma Science’s MEDIHONEY® is one of the leading brands of medical-grade honey dressings. The product, which was purchased by Derma Sciences from its long-term New Zealand-based partner Comvita in January 2017, generated $20 million sales globally in 2016. The deal gives Derma Sciences exclusive global market and intellectual property rights for the medical and professional market segments.

Revamil is another medical-grade honey produced in greenhouses and marketed as being suitable for all types of chronic wounds. It is available as a wound dressing, as 100% pure honey in small tubes, as a wound gel, and as a balm. Another competing brand with CE marking and FDA approval is L-Mesitran, which was available globally since 2002.

As mentioned earlier, sales of honey-based dressings are expected to rise in the future. To continue the momentum, they will need to stave off competition from other bioactive wound dressings such as alginate and foam dressings.


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