Related Experiment Videos
Hyaluronic acid in incision wound fluid: a clinical study with the Cellstick device in children
O T Pajulo1, K J Pulkki, K K Lertola
1Department of Paediatric Surgery, Turku University Central Hospital, Turku, Finland. olli..pajulo@utu.fi
Insights
Hyaluronic acid (HA) levels in surgical wound fluid decrease significantly between 3 and 24 hours post-operation in children. Wound fluid HA concentration is more variable early after surgery and correlates with patient age and lymphocytes.
Area of Science:
- Wound Healing Research
- Biomaterials in Surgery
- Pediatric Surgery
Background:
- Hyaluronic acid (HA) is implicated in scar reduction and scarless fetal wound healing.
- Understanding early wound healing dynamics is crucial for optimizing patient outcomes.
- The Cellstick device enables serial collection of wound fluid and inflammatory cells.
Purpose of the Study:
- To quantify hyaluronic acid (HA) concentration and cellular composition in pediatric surgical wound fluid at two early time points.
- To investigate the temporal changes and variability of HA in wound fluid following elective surgery.
- To explore correlations between HA levels, patient age, and wound cell populations.
Main Methods:
- The Cellstick device was inserted into incision wounds of 37 boys undergoing inguinal hernia repair.
- Wound fluid and cells were collected at 3 ± 1 hours and 24 ± 3 hours post-surgery.
- Hyaluronic acid concentration was measured, and differential cell counts of wound cells were performed.
Main Results:
- A significant decrease in hyaluronic acid (HA) concentration was observed from 3 ± 1 to 24 ± 3 hours post-surgery (p<0.001).
- The variance in HA concentration was significantly higher at 3 ± 1 hours compared to 24 ± 3 hours (p<0.01).
- Positive correlations were found between HA concentration and patient age (r=0.91, p<0.05) at 3 hours, and between HA and wound lymphocytes (r=0.38, p<0.05).
Conclusions:
- Hyaluronic acid (HA) concentration in pediatric surgical wound fluid peaks early and declines significantly within 24 hours.
- Wound fluid HA concentrations exhibit greater variability at 3 hours compared to 24 hours post-surgery in healthy boys.
- Early HA levels may be influenced by patient age and inflammatory cell presence, suggesting a role in acute wound healing.
Abstract:
When inserted into a human incision wound, the Cellstick device harvests inflammatory cells and collects wound fluid, reflecting time-related changes in cell populations and in wound fluid composition. Hyaluronic acid has been postulated to be an important factor in scar reduction in wound healing and in scarless fetal wound healing. The aim of this work was to determine the concentration and variation of hyaluronic acid and proportions of wound cells in closed surgical wounds in children at two time points. The Cellstick device was inserted subcutaneously into the wound at the end of an elective inguinal hernia operation on 37 healthy boys, and the devices were removed 3+/-1 or 24+/-3 hours after surgery. Haluronic acid concentration was measured from the wound fluid and a differential count of the wound cells was performed. There was a significant decrease in hyaluronic acid concentration from 3+/-1 to 24+/-3 hours after surgery (p<0.001, Kruskal-Wallis anova). The variance of hyaluronic acid concentration in wound fluid differed between the wounds at the two time points (p<0.01, Levene test for homogeneity of variance). A positive correlation between hyaluronic acid concentration and patient age (r=0.91, p<0.05, Spearman) at 3+/-1 hours post surgery and between HA and wound lymphocytes (r=0.38, p<0.05, Spearman) was also found. We conclude that the hyaluronic acid concentration in wound fluid peaks early in children and decreases significantly by 3 to 24 hours after surgery, and the concentrations in the wound fluid of healthy boys are more variable 3 hours than at 24 hours after surgery.