Honey, Gellan Gum and Hyaluronic Acid as Therapeutic Approaches for Skin Regeneration

Chronic wounds pose a significant health concern and their prevalence, stemming from different etiologies, is on the rise due to the global aging population, posing a substantial burden on healthcare systems in developed countries. This work aimed to develop and formulate new therapeutic options in the form of creams and dressings based on honey, gellan gum and hyaluronic acid, for preventing and treating chronic wounds across all stages. To address this, after the formulations were developed, in vitro cytocompatibility was determined. To confirm biocompatibility, a ovine wound model was used: full-thickness excisional wounds were treated with 3 formulations, namely gellan gum and honey sponges (GG-HNY), gellan gum, honey and hyaluronic acid sponges (GG-HA-HNY) and a honey-based cream (cream FB002). Daily assessments, including visual evaluation, and wound scoring, were conducted for 30 days. Following the study period, tissues were collected for histological analyses. The macroscopic examination revealed that all therapeutic groups facilitated lesion closure. Lesion size reduction, granulation tissue disappearance, and scar tissue development were consistent across all groups, with the group receiving cream demonstrating an advanced stage of healing. All groups achieved substantial wound closure by day 30, with no significant differences among them. Histopathological analysis following ISO standards revealed that GG-HA-HNY had the lowest ISO score, indicating minimal reactivity and inflammation, corroborated the in vitro cytocompatibility. Combining these insights with previous findings enhances our understanding of wound regeneration dynamics and contributes to refining therapeutic strategies for chronic wounds. The resultant formulations aim to outperform existing medical devices, delivering superior performance at a lower overall unit cost.