Abstract
Acute injuries, such as surgical and traumatic, heal normally in an organized and rapid manner. Studies point to the healing activity of hyaluronic acid in all phases of healing. The aim was to evaluate the effectiveness of hyaluronic acid in skin abrasions on the dorsum of rats to compare to usual products on the market. Seventy-two Wistar rats were subjected to excoriation of approximately 2.0 cm2 on the back by dermabrasion. According to the treatment, 3 groups were established: saline, chlorhexidine digluconate and 0.2% hyaluronic acid for 14 days. Animals were photographed on the 2nd, 7th, 10th and 14th postinjury days, and the index of healing of the abrasions was calculated. Biochemically, myeloperoxidase measurements of skin biopsies in addition to histological studies to assess the crust and epidermal layers were performed. The group treated with hyaluronic acid showed better re-epithelialization from the other groups (p < 0.05) on the 7th and 10th days. For the thickness of the crust, the hyaluronic acid group presented thinner crust than other groups on the 10th and 14th days (p < 0.05), but in the epidermis, no difference was observed between the groups studied. All groups showed an increase in myeloperoxidase enzyme on the 2nd day, but a decreasing on the 7th day. On the 10th day, there was a difference in the hyaluronic acid group compared to the other groups (p < 0.05). The application of 0.2% hyaluronic acid significantly accelerated the re-epithelialization of skin abrasions compared to saline and chlorhexidine digluconate.
Highlights
Wound healing is a complex biological process in which events occur in a coordinated and sequential manner involving interactions of various cell types, matrix components, proteases and cytokines [1]
Healing by first intention occurs by minimizing the volume of connective tissue deposited, generating minimal scarring and restoring the epithelial barrier against infections [2, 3, 4]. This kind of lesions affect only the superficial layer of the skin or mucous membranes, presenting a solution of continuity of the tissue, without loss or destruction of it, with slight bleeding, but they are usually extremely painful and do not represent a risk to the victim when isolated. These lesions are caused by a sharp or blunt instrument [5] and are similar to the superficial ulcers caused by the use of personal protective equipment (PPE), including face masks, continuous positive airway pressure (CPAP) masks and other devices among health professionals and patients, situations that have risen starkly during the current coronavirus disease (COVID-19) pandemic [6]
On the 14th day, even without a difference, the excoriations of the Hyaluronic acid (HA) group were all re-epithelialized differently from the other groups that still had a crust and a delay in re-epithelialization of more than 50% (Figure 1A, B)
Summary
Wound healing is a complex biological process in which events occur in a coordinated and sequential manner involving interactions of various cell types, matrix components, proteases and cytokines [1]. This kind of lesions affect only the superficial layer of the skin or mucous membranes, presenting a solution of continuity of the tissue, without loss or destruction of it, with slight bleeding, but they are usually extremely painful and do not represent a risk to the victim when isolated These lesions are caused by a sharp or blunt instrument [5] and are similar to the superficial ulcers caused by the use of personal protective equipment (PPE), including face masks, continuous positive airway pressure (CPAP) masks and other devices among health professionals and patients, situations that have risen starkly during the current coronavirus disease (COVID-19) pandemic [6]. Antiseptic products are used to clean the wound or only saline is used to maintain moisture
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