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Treatment of hard-to-heal leg ulcers with hyaluronic acid, sodium alginate and negative pressure wound therapy

By AGE2B team
September 17, 2021

Omer Arda Cetinkaya 1, Suleyman Utku Celik 2, Can Yahya Boztug 1, Hakan Uncu

Main idea: These results demonstrate that the combination of hyaluronic acid -sodium alginate -negative pressure wound therapy is a promising treatment for decreasing the healing time and increasing the success rate by their synergistic effect on wound healing in hard-to-heal lower extremity ulcers. However, further studies with a larger number of patients are needed to confirm the results.


Objective: Hard-to-heal lower extremity ulcer is a common healthcare problem and can lead to a poor quality of life (QoL). Despite the advances in wound care, conventional therapies, such as necrotic tissue debridement, cleansing, treatment of infection and local treatment with dressing application are still considered the standard of care in patients with hard-to-heal leg ulcers. However, managing hard-to-heal ulcers that do not respond well to these methods has led to new treatment strategies. In this study, the effects of hyaluronic acid (HA) and sodium alginate (SA), combined with negative pressure wound therapy (NPWT), in patients with hard-to-heal leg ulcers are evaluated.

Method: Patients with hard-to-heal lower extremity ulcers were treated with HA-SA combined with NPWT, or conventional therapy, between June 2014 and September 2015. Demographics, comorbidities, time to complete healing and change in wound area were recorded and compared.

Results: A total of 25 patients took part. Complete healing was achieved in 63.6% of the patients in the HA-SA with NPWT group, compared with 14.3% of the patients in the conventional therapy group. The mean decrease in wound size was significantly higher in the HA-SA-NPWT group than in the conventional therapy group. Despite a shorter healing period in the HA-SA-NPWT group than in the conventional group, no statistically significant difference was found between groups for time to complete healing.

Source NIH

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