Esterified Hyaluronic Acid Matrix Used Successfully in Non-healing Chronic Wounds for Patients Who Had Failed All Previous Therapies

Introduction: Chronic wounds are often unresponsive to initial therapy and can persist despite appropriate wound care (1).  Regenerative matrices that include hyaluronic acid have gained acceptance for the treatment of chronic wounds during the past two decades (2).  We report on the successful use of an esterified Hyaluronic Acid Matrix (eHAM) to treat patients with non-healing chronic wounds who had failed all previous therapies.
Objective: Evaluate wound healing following eHAM application in chronic wounds of patients who were unsuccessfully treated with other therapies.

Four patients with chronic diabetes-related wounds were evaluated. Case 1 presented with a 9 month lateral ankle and anterior shin wound with necrosis. Case 2 presented with a 22 year chronic lower extremity wound (LEW). Case 3 presented with a left metatarsal wound. Case 4 presented with a LEW following a failed split thickness skin graft (STSG). Following wound debridement, all patients received 1-3 eHAM applications.

All case subjects had previously failed other wound therapies which included skin flaps, STSG, negative pressure, and unsuccessful treatment with other dermal regenerative templates. All four case subjects successfully achieved wound healing within 4 to 6 weeks of the initial eHAM application. As few as one eHAM application was sufficient, with only Case 3 requiring three eHAM applications. High-quality granulation tissue and re-epithelialization was generated at the wound bed site following eHAM application.

All case subjects had previously failed other wound therapies which included skin flaps, FTSG, negative pressure, and unsuccessful treatment with other dermal regenerative templates. All four case subjects successfully achieved wound healing within 4 to 6 weeks of the initial eHAM application. As few as one eHAM application was sufficient, with only Case 3 requiring three eHAM applications. High-quality granulation tissue and re-epithelialization was generated at the wound bed site following eHAM application.

Trademarked Items (if applicable): Medline Hyalomatrix

References (if applicable): Xu D.H., Zhu Z., Fang Y. The Effect of a Common Antibiotics Doxycycline on Non-Healing Chronic Wound. Curr Pharm Biotechnol. Curr Pharm Biotechnol, 2017, 360-364.

Shaharudin A., Aziz Z. Effectiveness of hyaluronic acid and its derivatives on chronic wounds, a systematic review. J Wound Care. 2016, 25(10), 585-592.