Study Shows Healing Promise For Hyaluronan

By Brian McCurdy, Associate Editor

Can hyaluronan therapy help you achieve better treatment results with indolent diabetic foot ulcers? Indeed, researchers do believe that hyaluronan-containing dressings may provide adjunctive benefits in facilitating quicker healing. According to a recent study presented at the 15th Annual Symposium On Advanced Wound Care, a healing regimen that included the hyaluronan dressings took an average of 8.6 weeks. All 36 patients in the study underwent surgical debridement for their diabetic foot wounds and were placed on therapy consisting of hyaluronan dressings (Hyalofill, ConvaTec) with dressing changes taking place every other day. The study did not include a comparative group. Researchers used Hyalofill therapy until they achieved 100 percent granulation tissue in the wound bed, and then followed up with a moisture-retentive dressing until complete epithelialization occurred. The researchers evaluated both the time it took to achieve complete wound closure and the proportion of patients achieving wound closure within a 20-week evaluation period. According to the study, 75 percent of the wounds (measuring an average of 2.2 cm) healed within the 20-week follow-up period. “I believe the take-home lesson from this study is that (hyaluronan-containing dressings) may show promise in the treatment of diabetic foot wounds and, in our clinic, apparently had an excellent safety profile,” says David Armstrong, DPM, a co-author of the study and the Director of Research and Education within the Department of Surgery, Podiatry Section at the Southern Arizona Veterans Affairs Medical Center. Researchers hinted that the study’s treatment protocol may help to reduce the risk of lower extremity amputation in patients with diabetes. Dr. Armstrong says a follow-up, randomized controlled trial, which is already underway, may shed further light on the potential of hyaluronan. Alan J. Cantor, DPM, says the aforementioned study results are consistent with his extensive experiences in using hyaluronan and with European studies previously published. He adds that hyaluronan directly affects wound biology in ways which researchers are still discovering. “We are finding a dramatic enhancement of granulation tissue where other previous therapies failed,” notes Dr. Cantor, an Attending Surgeon within the Department of Surgery at the Nassau University Medical Center in East Meadow, New York. “We’re using (hyaluronan) on wounds of various etiologies and continually receiving positive responses.” While Dr. Cantor strongly encourages wound care clinicians to “understand and value” the adjunctive benefits of hyaluronan in their treatment selections, he underscores the fact that you should never overlook basic treatment tactics like offloading and infection management. “Advanced wound technology is only as effective as good, basic wound care,” he says. Can A New Protocol Offer Pressure Ulcer Relief? Pressure ulcers are a serious dilemma, particularly for patients in long-term care facilities. According to a 2001 report from the National Pressure Ulcer Advisory Panel, the incidence rate of pressure ulcers has increased from 2.2 percent to 23.9 percent in long-term care. The estimated national cost to heal pressure ulcers is between $1.68 billion and $6.8 billion annually. However, a recent study published in the April 2002 edition of Ostomy/Wound Management may provide new hope to these patients and their health care providers. Researchers from the Yale School of Nursing implemented an aggressive new protocol of care, which included managing and preventing chronic wounds, standardizing nutrition, staff education, repositioning, support surfaces and preventive skin care. What were the results? Over a five-month period, researchers achieved an 87 percent reduction of pressure ulcers at one facility and a 76 percent reduction at another facility. For more info on the study, check out the archives of – Gina DiGironimo Production Editor

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