To help heal seriously infected wounds, some surgeons have revived a 4,000-year-old treatment. Born on the battlefields of ancient Egypt: they pack the depths of treacherous wounds with sweet substances like sugar.

Dressings made of sugar and honey, favored by healers throughout history, fell into disfavor with the development of antibiotics over half a century ago. But even the most sophisticated modern preparations have proved unable at times to overcome the hearty bacteria that live in deep wounds, and a handful of doctors, mostly in Europe, are turning once again to sugar ”It’s a very old and very simple treatment which was forgotten for a while but is now coming back, like a fashion,” said Prof. Rudy Siewert, chairman of the department of surgery at the Klinikum Rechts der Isar in Munich, West Germany.

Experts say the ancient treatment probably works because sugar tends to draw water into its gritty midst, through osmosis. This action both dries the bed of the wound to promote new tissue growth and dehydrates the bacteria that cause infection, leaving them weak and fragile. Several American pharmaceutical concerns make expensive wound pastes composed of synthetic microscopic water-absorbing beads that perform this same function. Revival Began in U.S. Although sugar dressings have few American advocates, Europeans ascribe the current revival in part to the work of an American, Dr. Richard A. Knutson, an orthopedic surgeon in Greenville, Miss., who published one of the few papers on the technique a decade ago.

About 15 years ago, frustrated by stubborn, pus-filled wounds filled with bacteria resistant to all drugs, Dr. Knutson began experimenting with sugar dressings at the suggestion of a retired nurse who had worked in the Deep South before the antibiotic era.

”When we started I thought it was absolutely nuts,” Dr. Knutson said in a recent telephone interview. ”Sugar! The first thing you think about is the old jar of marmalade in the fridge growing all that junk. You think you’ll create a perfect medium for bacterial growth. That turned out not to be the case.”

Putting sugar on a wound reduces pain and speeds up the healing process

He has since used a salve made of sugar, which he now mixes with a mild bacteria-killing iodine liquid, on about 6,000 patients with anything from burns to shotgun wounds. The mixture is applied as a paste. ”It’s easy to use, painless, inexpensive, and it works,” he said, ”You can’t ask for more. If it has a fancy name and cost $300 a bottle everyone would be buying it.” Most European surgeons use sugar alone.

The care of deep wounds is a major challenge to surgeons. Although doctors sew up small clean cuts, the skin above penetrating injuries that are likely to be infected is generally left open, both to allow the doctors to clean the cavity and to allow the body to grow new tissue, called granulation tissue, from the deep wound base.