Tissue Engineering for Complex Wounds: Esterified Hyaluronic Acid Matrix (eHAM) Literature Review and Case Series

Background: Complex soft tissue injuries are difficult to heal and costly to treat. Current solutions are often insufficient to heal complex wounds. Tissue engineering for acute wounds is a new approach. Tissue engineering focuses on regenerating tissue based on the use of biologic scaffolds and cell signalling. New technologies use a tissue engineering approach to ensure a smooth transition between the phases of wound healing. Hyaluronic Acid (HA) has become a recent focus of interest. This study aimed to review the experience of patients treated with electrospun non-woven cross-linked hyaluronic acid matrix (eHAM) in the management of acute and chronic wounds. Methods: A case series study was performed of consecutive adults (age >18 years old) treated with eHAM to manage their wound within an 18-month period. Data were analysed for demographic information and time to healing. Results: 12 cases with full thickness wound depths were found in the 16 months of the study. Wound size for all patients decreased after the first eHAM application with mean delta wound size -56.99 cm2; 66.67% had a second eHAM application, 25% had a third eHAM application. 41.67% patients healed using just eHAM therapy. Conclusion: Our preliminary experience demonstrates that electrospun non-woven cross-linked hyaluronic acid matrix (eHAM) is a valuable tool to assist in the healing of complex wounds. In our study, many patients were able to heal using eHAM therapy alone. Clinical benefit was demonstrated after first eHAM application, where wound size was markedly reduced for all patients.