Article: Author: Dr. med. Claus von Schroeder, Facharzt für Allgemeinmedizin, Im Hagen 15, 29549 Bad Bevensen
Hyaluronic acid active substance combinations: The all-purpose weapons in local wound treatment
The medical application spectrum of hyaluronic acid (also: sodium hyaluronate, hyaluronan) is now very broad. It is used in most cases to accelerate healing and has become an indispensable part of the current repertoire of active substances in medicine.
In addition to local wound care, hyaluronic acid is also used very successfully in orthopaedics, ophthalmology and aesthetic medicine. In medicinal products, it usually functions as a carrier medium for other active ingredients. Especially the topical use of products containing hyaluronic acid proves to be very effective in complex, acute and chronic wounds, as they can positively control the complex healing processes.
This is because one of the important properties of hyaluronic acid is to bind a large number of water molecules, thereby ensuring the hydration of the skin and connective tissue. The presence of hyaluronic acid also fulfils an important function in cell differentiation, proliferation and migration throughout tissue regeneration and development.
The evidence is now very clear: in a recently published, prospective, multicentre, randomised, controlled, double-blind study with 168 patients, significantly better healing rates were observed in patients treated with hyaluronic acid compared to the control group.(1) According to various other studies, hyaluronic acid reduces biofilm (2), has an accelerating, positive effect on wound healing and the potential to reduce pain (3) and optimise scar formation (4).
Overall, it ensures higher healing rates and significantly shorter healing times. Hyaluronic acid has been scientifically proven to achieve very good clinical results in the following indications:
- Postoperative wounds (5)
- Military gunshot and shrapnel wounds (6)
- Skin ulcers (7)
- Decubital ulcers (8)
- Diabetic foot syndrome (DFS) (9)
- Negative pressure wound therapy (10)
- Inflammatory tattoo wounds (11)
- Complicated scarring wounds (12)
- Removal site for split skin grafts (13)
- Burn wounds (14).
Furthermore, it is ideal for wound therapy after resections or amputations or for postoperative suture insufficiencies. As hyaluronic acid is a natural, endogenous component, no significant undesirable side effects or counter-reactions have been recorded with oral, topical or injectable application.
The hyaluronic acid-containing products available on the market are available to users in different dosage forms such as granules, cream, membrane, spray, wound dressings or viscous fluid. In the past, native hyaluron was extracted from animal tissue; nowadays it is only produced by microbial fermentation. The associated simplification of the production process as well as the availability in larger quantities are the reasons why modern wound care products with highly concentrated hyaluronic acid are offered at an acceptable price-performance ratio, are increasingly in demand and can be used much more often - also for large-area wounds. For the physician, the price is a not insignificant aspect with regard to cost-conscious prescriptions or compliance with the principle of economic efficiency.
The latest generation of products that have an additional synergistic active complex in addition to hyaluronic acid are particularly suitable for universal use across all wound phases. An additive antiseptic (e.g. octenidine, iodine) allows these active agent combinations to be used in many ways, much earlier and across wound phases, even in wounds that are still infected. In addition to the advantages already mentioned, the very simple handling and the few necessary change intervals make them very effective and efficient medical products, so that they can justifiably be called an all-purpose weapon in local wound treatment, provided they are adequately indicated.
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