Managing Pathologic Scars by Injecting Auto-Cross-linked Hyaluronic Acid: A Preliminary Prospective Clinical Study

Riccio, Michele; Marchesini, Andrea; Senesi, Letizia; Skrami, Edlira; Gesuita, Rosaria; Francesco, Francesco De

doi:10.1007/s00266-018-01303-3

Cited by 14 publications

(9 citation statements)

References 59 publications

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“…Despite the great results obtained, this retrospective, observational, and longitudinal study had some limitations. Firstly is the lack of a comparison arm, as previously performed [41,48]. A further limitation was the lack of in vitro analysis, such as histological and immune-histochemical evaluation, which enables the analysis of an authentic regenerative potential regarding Bionect Start ® .…”

Section: Discussionmentioning

confidence: 99%

Hyaluronic Acid/Collagenase Ointment in the Treatment of Chronic Hard-to-Heal Wounds: An Observational and Retrospective Study

Francesco¹,

Francesco

Riccio³

2022

JCM

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Background: Wound bed preparation is an important concept in clinical practice and is related to adequate debridement. The use of proteolytic enzymes is an established method of enzymatic wound debridement, especially in hard-to-heal ulcers that are unresponsive to normal healing procedures and progress. The TIME framework (tissue, inflammation/infection, moisture balance, and edge of wound) offers an appropriate strategy to eliminate resistance to healing, as well as maximizing the healing process. Maintenance debridement, as opposed to sporadic debridement, may be proposed in preserving an adequate wound bed towards complete recovery. Collagenase has been effective in debridement due to its ability to degrade collagen and elastin. In this clinical context, collagenase taken from Vibrio alginolitycus is the most favorably expressed enzymatic debriding agent. Methods: This retrospective observational study evaluates the efficacy of an ointment based on hyaluronic acid and collagenase (Bionect Start®), considering a reduced healing time and greater healing quality. We included 70 patients with chronic wounds of different etiologies, including diabetes mellitus (20), post-traumatic ulcers (35), chronic burns of degrees I and II (10), and pressure ulcers (5). We analyzed wound characteristics using the wound bed score (WBS) concept, healing time, as well as operator and patient satisfaction. Results: Frequency of debridement efficacy in terms of wound bed cleansing varied from 26% after 2 weeks to 93% after 4 weeks. We observed complete healing in 62 patients within an eight-week period. The overall operator and patient satisfaction after 8 weeks were 100% and 90%, respectively. Moreover, all patients reported less pain. Conclusions: A combined action of hyaluronic acid and collagenase ointment demonstrated a reduction in healing time while improving healing quality, with a decrease in pain.

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Section: Discussionmentioning

confidence: 99%

Hyaluronic Acid/Collagenase Ointment in the Treatment of Chronic Hard-to-Heal Wounds: An Observational and Retrospective Study

Francesco¹,

Francesco

Riccio³

2022

JCM

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“…Based on these considerations, it is obvious that medical doctors cannot regulate the genetic risk factors of a pathological scar. Nevertheless, they can use a number of treatments that, remarkably, work by reducing inflammation like hyaluronic acid (Gao et al, 2019 ; Riccio et al, 2019 ), dermal micrograft (Svolacchia et al, 2016 ; Jimi et al, 2017b ). The etiology of skin fibrosis is unknown, albeit investigations proposing unknown antigens as the cause of T-cell activation thus provoking the above-mentioned mechanisms of disease onset.…”

Section: Discussionmentioning

confidence: 99%

A New Animal Model for Pathological Subcutaneous Fibrosis: Surgical Technique and in vitro Analysis

Marchesini

Francesco

Mattioli‐Belmonte

et al. 2020

Front. Cell Dev. Biol.

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Fibrosis is a condition that affects the connective tissue in an organ or tissue in the restorative or responsive phase as a result of injury. The consequences of excessive fibrotic tissue growth may lead to various physiological complications of deformity and impairment due to hypertrophic scars, keloids, and tendon adhesion without understating the psychological impact on the patient. However, no method accurately quantifies the rate and pattern of subcutaneous induced hypertrophic fibrosis. We, therefore, devised a rodent excisional model to evaluate the extent of fibrosis with talc. Tissue specimens were set on formalin, and paraffin sections for histological, immunohistochemical, and molecular analysis talc was used to induce the fibroproliferative mechanism typical of hypertrophic scars. This pathway is relevant to the activation of inflammatory and fibrotic agents to stimulate human hypertrophic scarring. This model reproduces morpho-functional features of human hypertrophic scars to investigate scar formation and assess potential anti-scarring therapies.

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“…Therapeutic strategies for treating hypertrophic scars include steroid injection, surgical hypertrophic scar removal, radiotherapy, compression, and cryotherapy, pulsed dye and CO 2 laser, silicone gel, nanoparticles and radiotherapy, among others ( Salameh et al, 2021 ; Ogawa, 2021 ; Svolacchia et al, 2016 ; Nicoletti et al, 2013 ; Riccio et al, 2019a ; Jimi et al, 2020 ; Barrera, 2003 ; Aoki et al, 2020 ). However, existing treatments are not guaranteed to reduce recurrence of keloids, due to the high recurrence rate thereof at the hypertrophic scar excision site ( Coentro et al, 2019 ; Kumar and Kamalasanan, 2021 ).…”

Section: Current Mainstream Strategies For Inhibiting Scar Formationmentioning

confidence: 99%

Use of Adipose Stem Cells Against Hypertrophic Scarring or Keloid

Chen

Hou

et al. 2022

Front. Cell Dev. Biol.

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Hypertrophic scars or keloid form as part of the wound healing reaction process, and its formation mechanism is complex and diverse, involving multi-stage synergistic action of multiple cells and factors. Adipose stem cells (ASCs) have become an emerging approach for the treatment of many diseases, including hypertrophic scarring or keloid, owing to their various advantages and potential. Herein, we analyzed the molecular mechanism of hypertrophic scar or keloid formation and explored the role and prospects of stem cell therapy, in the treatment of this condition.

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Managing Pathologic Scars by Injecting Auto-Cross-linked Hyaluronic Acid: A Preliminary Prospective Clinical Study

Cited by 14 publications

References 59 publications

Hyaluronic Acid/Collagenase Ointment in the Treatment of Chronic Hard-to-Heal Wounds: An Observational and Retrospective Study

Hyaluronic Acid/Collagenase Ointment in the Treatment of Chronic Hard-to-Heal Wounds: An Observational and Retrospective Study

A New Animal Model for Pathological Subcutaneous Fibrosis: Surgical Technique and in vitro Analysis

Use of Adipose Stem Cells Against Hypertrophic Scarring or Keloid

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