The Use of Hyalomatrix PA in the Treatment of Deep Partial-Thickness Burns

Abstract

Since 2001, Hyalomatrix PA (Fidia Advanced Biopolymers, Abano Terme, Italy) has been used in our center on pediatric burned patients as a temporary dermal substitute to cover deep partial-thickness burns after dermabrasion. This "bridge" treatment was adopted to remove necrotic debris (dermabrasion) and to stimulate regeneration in a humid and protected environment (Hyalomatrix PA). We present results obtained with this approach. On the third to fifth day after admission, dermabrasion was practiced on deep burned areas, which were covered with Hyalomatrix PA. Change of dressings was performed every 7 days. On day 21, those areas still without signs of recovery were removed with classic escharectomy and covered with thin skin grafts. We treated 300 patients. Sixty-one percent needed only one dermabrasion treatment, 22.3% (67 patients) more than one, and 16.7% (50 patients) the classic escharectomy. A total of 83% of patients healed within 21 days. Our study suggests that the combination of dermabrasion with a temporary dermal substitute could be a good and feasible approach for treatment of deep partial-thickness burns. Prospective randomized studies are now necessary to compare our protocol with the gold standard treatment of topical dressings.

Challenges in the Treatment of Chronic Wounds

“…[224][225][226][227][228][229][230][231][232][233] Another matrix dressing (Hyalomatrix Ò ; Anika Therapeutics, Inc., Bedford, MA) comprising primarily hyaluronan, one of the main constituents of ECM, has also been studied in Europe as a dermal substitute for use in burns, VLUs, and DFUs. [234][235][236][237] Integra Ò bilayer wound matrix (Integra LifeSciences, Plainsboro, NJ) is a dermal regeneration template in this category (bovine collagen, glycosaminoglycans, and silicone layer) that has primarily been used in burns for a number of years, but is being more frequently used in lower extremity chronic wounds and foot ulcers. 238,239 Although there are few published prospective studies to support their efficacy, most of these products are commercially available in the United States at relatively low cost and are approved for use in multiple chronic wound types.…”

A review of tissue-engineered skin bioconstructs available for skin reconstruction

“…Hyalomatrix PA has been investigated with favourable outcomes in a porcine preclinical model of full-thickness wounds (Myers et al 2007), and it has also been used clinically for the treatment of deep partial-thickness burns. The material served as a temporary dressing to stimulate wound regeneration after dermabrasion and was reported to be a good and feasible approach for such wound treatments (Gravante et al 2007). It is also reported to give favourable outcomes in deep paediatric burns treatment (Tamisani 2004).…”

Facilitating Healing of Granulating Wounds: Dressings, Dermal Substitutes, and Other Methods

“…Manufactured acellular dermal substitute Hyalomatrix Non-cross-linked hyaluronic acid matrix with outer silicone membrane Low tissue reactivity was found with Hyalomatrix when used in deep partial thickness wounds [47].…”

“…The main advantage is a low inflammatory response. Hyalomatrix® (Anika Theraputics) is a noncross-linked hyaluronic acid matrix with outer silicone membrane used in burns, diabetic ulcers, and chronic wounds [47].…”