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Research (Published online: 28-10-2015)

16. Application of hyaluronic acid in the healing of non-experimental open wounds: A pilot study on 12 wounds in 10 client-owned dogs - Roberta Ferrari, Patrizia Boracchi, Stefano Romussi, Giuliano Ravasio and Damiano Stefanello

Veterinary World, 8(10): 1247-1259

 

 

   doi: 10.14202/vetworld.2015.1247-1259

 

Roberta Ferrari: Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; roberta.ferrari@unim.it

Patrizia Boracchi: Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy;

patrizia.boracchi@unimi.it

Stefano Romussi: Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; stefano.romussi@unimi.it

Giuliano Ravasio: Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; giuliano.ravasio@unimi.it

Damiano Stefanello: Department of Veterinary Science and Public Health, University of Milan, Milan, Italy; damiano.stefanello@unimi.it

 

Received: 01-07-2015, Revised: 14-09-2015, Accepted: 23-09-2015, Published online: 28-10-2015

 

Corresponding author: Roberta Ferrari, e-mail: roberta.ferrari@unim.it


Citation: Ferrari R, Boracchi P, Romussi S, Ravasio G, Stefanello D (2015) Application of hyaluronic acid in the healing of non-experimental o pen wounds: A pilot study on 12 wounds in 10 client-owned dogs, Veterinary World 8(10): 1247-1259.



Aim: Veterinarians have frequently to deal with wounds to the skin, subcutis, and underlying muscle. The aim was to explore the application of hyaluronic acid (HA)-containing dressing on open skin wounds in dogs. The progress of healing was assessed by wound area reduction and two scoring scales applied in human medicine.

Materials and Methods: Ten client-owned dogs with 12 cutaneous open wounds healed by the second intention were included. All wounds were treated using available in commerce HA-containing wound dressing from admission to complete re-epithelialization. At every clinical examination, wound area and scale scoring assessments were performed.

Results: After debridement, an increased wound size was obtained while an improvement was determined by both grading systems. The median numbers of return to the clinic for bandage change were 5 times. The median time to complete wound healing was 34.5 days. The mean wound area at day 7, 14, 21, and 28 were, respectively, 90.4%, 47.7%, 22.4%, and 14.8% of the original size (for linear measurement) and 95.5%, 54.4%, 23.10%, and 14.8% of the original size (for software measurement). Regarding wound healing assessment tools, the agreement between two operators was considered high for both scales.

Conclusions: HA-containing dressing may be a possible wound treatment for cutaneous open wounds in dogs. The assessment of wound quality using scale scoring system could be useful especially in the 1st week and to direct clinical decision-making process.

Keywords: advance wound dressing, canine, wound assessment.



1. Pavletic, M.M. (2010) Basic principles of wound healing. In: Pavletic MM, editor. Atlas of Small Animal Wound Management and Reconstructive Surgery. 3rd ed. John Wiley and Sons Ltd., Chichester, West Sussex, UK. p18-28.
 
2. Dernell, W.S. (2006) Initial wound management. Vet. Clin. Small Anim. Pract., 36: 713-38.
http://dx.doi.org/10.1016/j.cvsm.2006.04.003
PMid:16787785
 
3. Anderson, D. (1996) Wound management in small animal practice. Practice, 18: 115-128.
http://dx.doi.org/10.1136/inpract.18.3.115
 
4. Cantatore, M., Renwick, M.G. and Yool, D.A. (2013) Combined Z-plasty and phalangeal fillet for reconstruction of a large carpal defect following ablative oncologic surgery. Vet. Comp. Orthop. Traumatol., 26: 510-514.
http://dx.doi.org/10.3415/VCOT-12-11-0134
PMid:24008498
 
5. Prpich, C.Y., Santamaria, A.C., Simcock, J.O., Wong, H.K., Nimmo, J.S. and Kuntz, C.A. (2014) Second intention healing after wide local excision of soft tissue sarcoma in the distal aspects of the limbs in dogs: 31 cases (2005-2012). J. Am. Vet. Med. Assoc., 244: 187-194.
http://dx.doi.org/10.2460/javma.244.2.187
PMid:24378028
 
6. Liptak, J.M. (1997) An overview of the topical management of wounds. Aust. Vet. J., 75: 408-413.
http://dx.doi.org/10.1111/j.1751-0813.1997.tb14342.x
PMid:9247688
 
7. Pitt, K.A. and Stanley, B.J. (2014) Negative pressure wound therapy: Experience in 45 dogs. Vet. Surg., 43: 380-387.
http://dx.doi.org/10.1111/j.1532-950X.2014.12155.x
PMid:24512302
 
8. Yang, G., Prestwich, G.D. and Mann, B.K. (2011) Thiolated carboxymethyl-hyaluronic-acid-based biomaterials enhance wound healing in rats, dogs, and horses. ISRN Vet. Sci., 2011: Article ID:851593.
http://dx.doi.org/10.5402/2011/851593
 
9. Hadley, H.S., Stanley, B.J., Fritz, M.C., Hauptman, J.G. and Steficek, B.A. (2013) Effect of a cross-linked hyaluronic acid based gel on the healing of open wounds in dogs. Vet. Surg., 42: 161-169.
http://dx.doi.org/10.1111/j.1532-950X.2012.01048.x
PMid:23153045
 
10. Bischonfberger, A.S., Dart, C.M., Perkins, N.R., Kelly, A., Jeffcott, L. and Dart, A.J. (2013) The effect of short-and long-term treatment with manuka honey on second intention healing of contaminated and noncontaminated wounds on the distal aspect of the forelimbs in horses. Vet. Surg., 42: 154-160.
http://dx.doi.org/10.1111/j.1532-950X.2012.01083.x
PMid:23216146
 
11. Berry, D.B. II. and Sullins, K.E. (2003) Effect of topical application of antimicrobials and bandaging on healing and granulation tissue formation in wounds of the distal aspect of the limbs in horses. Am. J. Vet. Res., 64: 88-92.
http://dx.doi.org/10.2460/ajvr.2003.64.88
PMid:12518884
 
12. Mullally, C., Carey, K. and Seshadri, R. (2010) Use of a nanocrystalline silver dressing and vaccum-assisted closure in a severely burned dog. J. Vet. Emerg. Crit. Care, 20: 456-463.
http://dx.doi.org/10.1111/j.1476-4431.2010.00564.x
PMid:20731813
 
13. Demaria, M., Stanley, B.J., Hauptman, J.G., Steficek, B.A., Fritz, M.C., Ryan, J.M., Larn, N.A., Moore, T.W. and Hadley, H.S. (2011) Effects of negative pressure wound therapy on healing of open wounds in dogs. Vet. Surg., 40: 658-669.
http://dx.doi.org/10.1111/j.1532-950X.2011.00849.x
PMid:21770975
 
14. Tambella, A.M., Attili, A.R., Dini, F., Palumbo, A., Vullo, C., Serri, E., Scrollavezza, P. and Dupré, G. (2014) Autologous platelet gel to treat chronic decubital ulcers: A randomized, blind controlled clinical trial in dogs. Vet. Surg, 43: 726-733.
http://dx.doi.org/10.1111/j.1532-950x.2014.12148.x
 
15. Price, R.D., Berry, M.G. and Navsaria, H.A. (2007) Hyaluronic acid: The scientific and clinical evidence. J. Plast. Reconstr. Aesthet. Surg., 60: 1110-1119.
http://dx.doi.org/10.1016/j.bjps.2007.03.005
PMid:17466613
 
16. Necas, J., Bartosikova, L., Brauner, P. and Kolar, J. (2008) Hyaluronic acid (Hyaluronan): A review. Vet. Med (Praha)., 53: 397-411.
 
17. Gao, F., Liu, Y., He, Y., Yang, C., Wang, Y., Shi, X. and Wei, G. (2010) Hyaluronan oligosaccharides promote excisional wound healing through enhanced angiogenesis. Matrix Biol., 29: 107-116.
http://dx.doi.org/10.1016/j.matbio.2009.11.002
PMid:19913615
 
18. Aya, K.L. and Stern, R. (2014) Hyaluronan in wound healing: Rediscovering a major player. Wound Repair Regen., 22: 579-593.
http://dx.doi.org/10.1111/wrr.12214
 
19. Bourguignon, L.Y., Ramez, M., Gilad, E., Singleton, P.A., Man, M.Q., Crumrine, D.A., Elias, P.M. and Feingold, K.R. (2006) Hyaluronan-CD44 interaction stimulated keratinoyte differentiation, lamellar body formation/secretion, and permeability barrier homeostasis. J. Invest. Dermatol., 126: 1356-1365.
http://dx.doi.org/10.1038/sj.jid.5700260
PMid:16557236
 
20. Abatangelo, G., Martelli, M. and Vecchia, P. (1983) Healing of hyaluronic acid-enriched wounds: Histological observations. J. Surg. Res., 35: 410-406.
http://dx.doi.org/10.1016/0022-4804(83)90030-6
 
21. Marushita, T., Nakayama, Y., Hirano, T. and Ohashi, S. (1996) Acceleration of granulation tissue ingrowth by hyaluronic acid in artificial skin. Br. J. Plast. Surg., 49: 58-63.
http://dx.doi.org/10.1016/S0007-1226(96)90188-5
 
22. Onesti, M.G., Fioramonti, P., Carella, S., Fino, P., Sorvillo, V. and Scuderi, N. (2013) A new association between hyaluronic acid and collagenase in wound repair: An open study. Eur. Rev. Med. Pharmacol. Sci., 17: 210-216.
PMid:23377810
 
23. Ruiz-Cardona, L., Sanzgiri, Y.D., Benedetti, L.M., Stella, V.J. and Topp, E.M. (1996) Application of benzyl hyaluronate membranes as potential wound dressings: Evaluation of water vapour and gas permeabilities. Biomaterials, 17: 1639-1643.
http://dx.doi.org/10.1016/0142-9612(95)00324-X
 
24. Choi, Y.S., Lee, S.B., Hong, S.R., Lee, Y.M., Song, K.W. and Park, M.H. (2001) Studies on gelatin-based sponges. Part III: A comparative study of cross-linked gelatin/alginate, gelatin/hyaluronate and chitosan/hyaluronate sponges and their application as a wound dressing in full-thickness skin defect of rat. J. Mater. Sci. Mater. Med., 12: 67-73.
http://dx.doi.org/10.1023/A:1026765321117
PMid:15348379
 
25. Voigt, J. and Driver, V.R. (2012) Hyaluronic acid derivatives and their healing effect on burns, epithelial surgical wounds, and chronic wounds: A systemic review and meta-analysis of randomized controlled trials. Wound Repair Regen., 20: 317-331.
http://dx.doi.org/10.1111/j.1524-475X.2012.00777.x
PMid:22564227
 
26. Liu, Y., Shu, X.Z., Gray, S.D. and Prestwich, G.D. (2004) Disulfide-crosslinked hyaluronan-gelatin sponge: Growth of fibrous tissue in vivo. J. Biomed. Mater. Res., 68: 142-149.
http://dx.doi.org/10.1002/jbm.a.10142
PMid:14661259
 
27. St-Supery, V., Tahiri, Y., Sampalis, J., Brutus, J.P., Harris, P.G. and Nikolis, A. (2011) Wound healing assessment - Does the ideal methodology for a research setting exist? Ann. Plast. Surg., 67: 193-200.
http://dx.doi.org/10.1097/SAP.0b013e3181f3e0e8
PMid:21587059
 
28. McNees, P. (2006) Skin and wound assessment and care in oncology. Semin. Oncol. Nurs., 22: 130-143.
http://dx.doi.org/10.1016/j.soncn.2006.04.003
PMid:16893742
 
29. Doughty, D.B. (2004) Wound assessment: Tips and technique. Adv. Skin Wound Care, 17: 369-372.
http://dx.doi.org/10.1097/00129334-200409000-00017
 
30. Lund, E.M., Amstrong, P.J., Kirk, C.A., Kolar, L.M. and Klausner, J.S. (1999) Health status and population characteristics of dogs and cats examined at private veterinary practices in the United States. J. Am. Vet. Med. Assoc., 214: 1336-1341.
PMid:10319174
 
31. Bates-Jensen, B.M. (1997) The pressure sore status tool – A few thousand assessments later. Adv. Wound Care, 10: 65-73.
PMid:9362584
 
32. Sussman, C. and Bates-Jensen, B. (2007) Wound Care: A Collaborative Practice Manual for Health Professionals. 3rd ed. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, PA, USA.
 
33. Harris, C., Bates-Jensen, B., Parslow, N., Raizman, R., Singh, M. and Ketchen, R. (2010) Bates-Jensen wound assessment tool: Pictorial guide validation project. J. Wound Ostomy Continence Nurs, 37: 253-259.
http://dx.doi.org/10.1097/WON.0b013e3181d73aab
PMid:20386331
 
34. Falanga, V., Saap, L.J. and Ozonoff, A. (2006) Wound bed score and its correlation with healing of chronic wounds. Dermatol. Ther., 19(6): 383-390.
http://dx.doi.org/10.1111/j.1529-8019.2006.00096.x
PMid:17199681
 
35. Schultz, G.S., Barillo, D.J., Mozingo, D.W., Chin, G.A. and The Wound Bed Advisory Board Members. (2004) Wound bed preparation and a brief history of TIME. Int. Wound J., 1(1): 19-32.
http://dx.doi.org/10.1111/j.1742-481x.2004.00008.x
PMid:16722894
 
36. Frenkel, J.S. (2014) The role of hyaluronan in wound healing. Int. Wound J., 11: 159-163.
http://dx.doi.org/10.1111/j.1742-481X.2012.01057.x
PMid:22891615
 
37. Humbert, P., Mikosiski, J., Benchikhi, H. and Allaert, F.A. (2013) Efficacy and safety of a gauze pad containing hyaluronic acid in treatment of leg ulcers of venous or mixed origin: A double-blind, randomized, controlled trial. Int. Wound J., 10: 159-166.
http://dx.doi.org/10.1111/j.1742-481x.2012.00957.x
 
38. Gravante, G., Sorge, R., Merone, A., Tamisani, A.M., Di Lonardo, A., Scalise, A., Doneddu, G., MElandri, D., Stracuzzi, G., Onesti, M.G., Cerulli, P., Pinn, R. and Esposito, G. (2010) Hyalomatrix PA in burn care practice – Results from a national restrospective survey, 2005 to 2006. Ann. Plast. Surg., 64: 69-79.
http://dx.doi.org/10.1097/SAP.0b013e31819b3d59
PMid:20010411
 
39. Goldman, R.J. and Salcido, R. (2002) More than one way to measure a wound: An overview of tools and techniques. Adv. Skin Wound Care, 15: 236-245.
http://dx.doi.org/10.1097/00129334-200209000-00011
 
40. Keast, D.H., Bowering, C.K., Evans, A.W., Mackean, G.L., Burrows, C. and D'Souza, L. (2004) MEASURE: A proposed assessment framework for developing best practice recommendations for wound assessment. Wound Repair Regen., 12 3 Suppl: S1-S17.
http://dx.doi.org/10.1111/j.1067-1927.2004.0123S1.x
PMid:15230830
 
41. Braumann, C., Guenther, N., Menenakos, C., Muenzberg, H., Pirlich, M., Lochs, H. and Mueller, J.M. (2011) Clinical experience derived from implementation on a easy to use concept for treatment of wound helaing by secondary intention and guidance in selection of appropriate dressing. Int. Wound J., 8: 253-260.
http://dx.doi.org/10.1111/j.1742-481X.2011.00777.x
PMid:21401884
 
42. Anderson, D. (2009) Management of open wounds. In: Williams, J., Moores, A., editors. BSAVA Manual of Canine and Feline Wound Management and Reconstruction. 2nd ed. British Small Animal Veterinary Association, Quedgeley, Gloucester, (UK). p37-53.
 
43. Donohue, K., Saap, L. and Falanga, V. (2002) Abstract: Clinical classification of wound bed preparation and its correlation for healing of venous ulcers. Proceeding of the 63rd Annual Meeting for the Society of Investigative Dermatology. May 15-18. Los Angeles, California.