A comparison of tissue-engineered hyaluronic acid dermal matrices in a human wound model

The derivatives of hyaluronic acid (hyaluronan) have been extensively studied in the field of tissue engineering. Several forms of the material are available (benzyl esters of hyaluronic acid, HYAFF), with differing degradation profiles. This study compared 2 such products used for dermal regeneration (HYAFF p80 and HYAFF p100, the partial and total benzyl ester of hyaluronan, respectively), in a human model. In a prospective, randomized, controlled trial, 20 tattoos were tangentially excised and 1 of 2 hyaluronic acid-derived dermal matrices were applied to the wound bed. The partial ester was changed after 1 week and the total ester was kept for 2 weeks. After 2 weeks, cultured epidermal autograft was applied using the Laserskin method. Wounds were subsequently assessed by several modalities and by such features as rate of epithelialization, wound contraction, and histologic and immunohistologic appearances. Subtle differences were seen between the 2 groups, indicating that the total ester, which showed better clinical performance, could be used, especially in burns. This has the advantage of a single application for a 2-week period, rather than the comparison material, a partial ester, which requires weekly changing and degrades faster. Further, the method of epidermal grafting with a dermal substitute shows excellent results and adds to the armory for the treatment of both chronic and acute wounds.