Treatment of Chronic Lower Extremity Wounds in Diabetic Patients Using an Esterified Hyaluronic Acid Matrix

Abstract Body: Lower extremity wounds largely consist of venous leg ulcers and diabetic foot ulcers. Many are the result of traumatic leg injuries, peripheral arterial disease or infection.  Poor care and wound treatment will often result in long term recovery with possible amputation to the injury site.  We evaluated an esterified hyaluronic acid matrix in diabetic patients with lower extremity wounds.  This is a case study of three chronic lower extremity wounds.  Method: Three diabetic patients with LEWs were evaluated in this case study. Case 1; presented with a slow healing TLI caused by a dog bite. Case 2; presented with a chronic 3-year non-healing VLU.  Case 3; presented with a chronic 2-year transmetatarsal amputation due to DFU. Following preparation of the wound site, eHAM was applied 2-6 times during treatment. The eHAM silicone layer was removed at 2-3 weeks depending on granulation.  Results: Case 1; received 2 applications of eHAM and at 4 weeks had 90% wound closure, Case 2 and 3; had good closure of the VLU within 2-4 weeks of eHAM application.  Both cases 2 and 3 had been minimally responsive to other wound care treatments however, following eHAM treatment a much more rapid response was noted. Conclusion: We conclude that eHAM is an effective treatment for LEW patients with chronic non-healing DFU and VLU or slow healing TLI.  Proper wound care and eHAM can improve wound closure in patients who were previously unresponsive to treatment.