(CS-032) Use of an Esterified Hyaluronic Acid Matrix (eHAM) to Treat Wounds in Complex Pediatric Patient

Introduction: Introduction. An esterified hyaluronic acid matrix eHAM has been shown to provide a suitable scaffold for endothelial cell migration and tissue vascularization. 1 The eHAM has ideal wound healing properties by providing a three-dimensional biodegradable scaffolding that supports cellular colonization and wound bed granulation. 2 The eHAM creates a microenvironment that promotes wound healing through cellular proliferation, angiogenesis, re-epithelization, and tissue regeneration. 3

Methods: Methods. Patient 1 presented with a surgical abdominal wound s/p necrotizing enterocolitis and bowel resection (initial wound size=15.83 cm2 ). Patient 1 received one eHAM application. Patient 2 presented with a surgical wound s/p resection of left labial/perineal sarcoma after radiation treatment (initial wound size=5.85 cm2 ). Patient 2 underwent hyperbaric therapy (10 dives) following one eHAM application. Patient 3 and Patient 4 presented with spina bifida and stage IV pressure injury of the sacral area (initial wound size=8.34 cm2 and 26.91 cm2 , respectively). Patient 3 received three eHAM applications following debridement. Patient 3 also received a further deep sharp debridement followed by application of a fetal bovine dermal scaffold. Patient 4 received two eHAM applications.

Results: Results. Following treatment, wound healing was observed for Patient 1 (8 weeks), Patient 2 (4 weeks), Patient 3 (68 weeks), and Patient 4 (48 weeks). The rate of wound healing for the two patients that underwent surgery (Patients 1 and 2) averaged 1.72 ± 0.37 cm2 per week. The two patients with stage IV pressure injuries related to spina bifida (Patients 3 and 4) averaged 0.34 ± 0.31 cm2 per week.

Discussion: Objective. The objective of our case study was to evaluate the wound healing capacity of an eHAM in four complex pediatric patients.

Conclusion. These results show that eHAM is an effective wound healing treatment for complex pediatric patients with surgical wounds and stage IV pressure injuries resulting from spina bifida.