**4. Summary**

and found American buckwheat honey exhibits high ROS inhibition ability. Many clinical studies have been performed on the basis of the antimicrobial effect of honey [143–145]. Clinical studies and bioactivity demonstrate the efficiency of honey in wound healing, maintaining a moist environment, promoting drainage of wound exudate and autolytic debridement [144]. It has been reported in minimizing malodour and scar formation of the wound [145] as well

Sasikala et al. [147] developed a chitosan-based film dressing loaded with Manuka honey. They identified chitosan–lactic acid with 6% honey showed ideal dressing properties in terms of water vapor transmission rate, water absorption, tensile strength, elongation, and antibacterial activity against *E. coli* and *S. aureus.* **Table 4** summarizes the commercially available honey-

**Dressing type Product Name Honey type**

Hydrocolloid MediHoney Leptospermum honey

Alginate-based MediHoney Leptospermum honey

Pure honey Surgihoney Bioengineered honey

Fibers MANUKAhd Manuka honey

Foam Ligasano Honeycomb

Pure honey MGO Manuka Honey Manuka honey

Sterile Manuka honey ManukaFill Manuka honey

Honey-impregnated gauze Manuka IG Manuka honey

Sheets, ribbon, gel TheraHoney Manuka honey

Knitted viscose mesh dressing, pure honey Activon Manuka honey

Alginate ribbon and dressing Algivon Manuka honey

Composite, foam/silicone dressings Actilite Manuka honey

**Table 4.** List of selected commercially available honey dressings used in wound healing [22, 148, 149].

Nonadherent gauze fibers MelDra Buckwheat honey

Natural and synthetic polymers are widely used in acute and chronic wound healing due to their biodegradability, biocompatibility, and wound exudate handling capacity. However, some polymers themselves have an antimicrobial activity [150]. The combination of polymers and antimicrobial drugs provides effective dressings to improve wound healing. Biazar et al.

as angiogenic activity [146].

386 Wound Healing - New insights into Ancient Challenges

based dressings currently sold on the market.

**3.6. Polymer-based antimicrobial dressings**

In this chapter, wound healing processes and types of dressings incorporating antimicrobial agents have been briefly discussed. Antimicrobials loaded into dressings for direct application to infected wound sites are becoming more popular worldwide in terms of safety, efficacy, cost effective, and convenience. The key antimicrobial agents ranging from antiseptics such as iodine, metals such as silver, antibiotics such as cephalosporins and aminoglycosides as well as natural products such as honey have been covered. In addition, the driving forces behind the developing of advanced therapeutic dressings have been reviewed. Furthermore, this review has demonstrated different and wide range of antimicrobial-loaded dressings, and a few clinical studies and commercially available antimicrobial dressings have been highlighted. Given the wide range of scientific studies and commercial products publicly available, it is evident that more evidence-based clinical trials are required to select appropriate dressings for the patients. It is also important to note the interdisciplinary fields (including formulation technology, biopharmaceutics, microbiology, materials and polymer chemistry and molecular biology) required for developing an effective antimicrobial dressing able to treat infection and also contribute towards enhanced wound healing.
