치료하기 어려운 창상에서 하이알로매트릭스® 의 사용

Abstract

PURPOSE: Although traditional and current treatment strategies may demonstrate success, persistence or recurrence of difficult-to-heal wounds remain significant problems. A novel product, Hyalomatrix(R) (Fidia Advanced Biopolymer, Abano Terme, Italy) is a bilayer of an benzyl esterified hyaluronan scaffold beneath a silicone membrane. The scaffold delivers hyaluronan to the wound, and the silicone membrane acts as a temporary epidermal barrier. We present the results obtained with Hyalomatrix(R) in the treatment of difficult-to-heal wounds. METHODS: From November, 2008 to March, 2010, Hyalomatrix(R) has been used on total 10 patients with wounds that were expected difficult to heal with traditional and other current strategies. After average 37.4 days from development of wounds, Hyalomatrix(R) was applied after wound debridement. On the average, Hyalomatrix(R) application period was 17.6 days. After average 16.5 days from removal of Hyalomatrix(R) , skin grafts was performed. RESULTS: In all cases, regeneration of fibrous granulation tissues and edge re-epithelization were present after the application of the Hyalomatrix(R) . And all of the previous inflammatory signs were reduced. After skin grafts, no adverse reactions were recorded in 9 cases. But in one case, postoperative wound infection occured due to a lack of efficient fibrous tissues. In this model, the Hyalomatrix(R) acts as a hyaluronan delivery system and a barrier from the external environments. In tissue repair processes, the hyaluronan performs to facilitate the entry of a large number of cells into the wounds, to orientate the deposition of extracellular matrix fibrous components and to change the microenvironment of difficult-to-heal wounds. CONCLUSION: Our study suggests that Hyalomatrix(R) could be a good and feasible approach for difficult-to-heal wounds. The Hyalomatrix(R) improves microenvironments of difficult-to-heal wounds, reduces infection rates and physical stimulus despite of aggravating factors