Hyalofill Hyalogran Hyalosafe

Hyaluronic Acid-based
Advanced Wound Care Products
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®
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Hyalofill Hyalogran Hyalosafe
Product presentation
Hyalogran®
2
Hyalogran®
Product description
Hyalogran® is a wound dressing made of microgranules of sodium alginate and HYAFF 11 (11%).
Hyalogran® is designed to provide an effective
debridement of chronic wounds and re-activate
the healing process compromised by the presence
of necrotic tissue.
3
Hyalogran®
HOW to use it
®
§  After cleansing the lesion, Hyalogran must be applied directly on the
wound bed.
§  A layer of approximately 3 mm should be applied on the wound bed (by
absorbing the wound fluids and bacteria, the microgranules increase in
size. Therefore, complete filling up of the wound cavity with Hyalogran®
could cause discomfort to the patient).
§  Hyalogran® should be covered with a suitable dressing, held in place with
surgical tape or bandage, as appropriate.
4
Hyalogran®
Dressing change
§  Hyalogran® can be easily removed with sterilized water or saline
Frequency of dressing change
§  Dressing changes depend on the exudative level of the wound.
§  The interval between changes may be extended up to 4 days.
5
Hyalofill®
6
Hyalofill®
Product description
§  Hyalofill® is an absorbent, bioactive wound
dressing.
§  It is composed of HYAFF11p75 (partial ester
of hyaluronan).
7
Hyalofill® Core Positioning
HOW to use it
§  For accomplished wound management
clinicians caring for hard-to-heal
diabetic, venous and pressure ulcers
§  Hyalofill creates a hyaluronic acid
enriched environment that is supportive
of the moist wound healing process in
difficult-to-heal wounds
8
Hyalofill®
Mechanism of Action
®
As Hyalofill is applied directly on the lesion, it absorbs the wound fluids, and
it becomes a gel which covers the lesion and creates a hyaluronan-rich
microenviroment.
The slow release of HA favors the granulation process and, as a consequence,
the wound healing.
WHEN to use it?
To stimulate granulation tissue formation and re-epithelialization
9
Hyalofill®
HOW to use it
§  After properly cleansing the wound, HYALOFILL is applied on the wound and
covered with a secondary dressing (it is also possibile to apply an
absorbent dressing in case of a highly exudative wound)
§  HYALOFILL can be easily removed with saline solution or with sterilized
forceps.
10
Case Studies Hyalogran®
®
Hyalogran
Case Series
11
Case 1: stage IV pressure ulcer (I)
64-year-old male
§  The patient was bed confined for a long
hospital admission due to an ischemic
stoke. He was af fected by ar terial
hypertension, carotid atherosclerosis and
urinary incontinent; the patient was on
enteral feeding. Due to the poor general
conditions and the immobilization in bed,
the patient developed a stage IV sacral
pressure ulcer. Previously it had been
managed with hydrocolloids (gel) and
polyurethane foams, with no success.
§  Malodorous, moderately exudating deep
cavity wound showing wet necrosis
§  Initiated Hyalogran® wound management
along with systemic antibiotic therapy.
§  Dressing change: every 2 days.
12
Case 1: stage IV pressure ulcer (II)
T 30 days: quite clean wound bed, infection almost
eradicated, debridment completed, healthy wound
margins. As debridement was not necessary
anymore, it was decided to go for Hyalofill® induced wound granulation, with weekly
applications
T 180 days: thanks to Hyalofill® wound
management the wound was almost closed.
Well-bleeding wound bed, healthy wound
margings with undergoing re-epithelialization,
no signs of infection. Weekly Hyalofill®
applications were continued until complete
healing
13
Case 2: poor outcome of toe amputation (I)
72 year-old diabetic male patient,
presenting a poor amputation outcome of
the V left toe. The lesion is covered by
fibrin, moderately exuding with callous
margins.
After courettage, Hyalogran® is applied to
aid the debridement process, to manage
the exudate and kick-start (thanks to the
HYAFF®component) the healing process.
On top of Hyalogran® a non-adherent
gauze and cotton bandages were used as
secondary dressing. Hyalogran® was reapplied every three days.
14
Case 2: poor outcome of toe amputation (II)
T 10 days : wound decreasing in size,
absence of non-vital tissue, clean, noninfected, granulating wound bed. Healthy
margins, re-epithelialization clearly ongoing from wound edges (*). Hyalogran®
dressing change every 3 days, secondary
dressing as before
T 21 days: the lesion has compeltaly reepithelialised after 3 weeks. In this
potentailly serious case, Hyalogran® has
been able to provide an effective but mild
wound debridement, absorbing the
exudate and, thanks to the
HYAFF®component, to kick start the
healing process
15
Case 3: abdominal wound dehiscence in an
obese patient (I)
78-year-old type I diabetic female.
Obese patient, affected by chronic renal
failure. The patient developed a wound
dehiscence after haematoma dumping
following an invasive ar teriography
procedure.
Large exuding lesion, with loss of tissue,
fibrinuos wound bed. Sharp, non-vital
wound edges, critical bacterial colonization.
Cleansing with saline and disinfection with
0.05% ipochloride solution. Hyalogran®
application to get rid of fibrinous material
and to manage the exudate. Secondary
dressing with non-woven cotton gauzes and
ipoallergenic plaster. An adbominal
compression garment was also worn.
Dressing change every 3 days. 16
Case 3: abdominal wound dehiscence in an
obese patient (II)
T 88 days: consistent wound reduction in size,
clean and granulating wound bed, still a
moderate exudate production but with no signs
of critical bacterial colonization. Sharp and vital
wound edges, not hyperaemic, healthy,
perilesional skin. Wound cleansing with saline
solution. It was decided to shift to Hyalofill in
order to speed up granulation and the reepithelialization process. Secondary dressing as
before. Weekly dressing changes.
T 180 days: in this quite complex and
compromized patient, the wound completely reepithelialized within 6 months, with a fair-good
qu a l i t y o f t h e n e o - d e r m i s ( a b d o m i n a l
compressive garment always worn).
17
Case 4: malleolar vasculitic ulcer (I)
76 year-old male
Affected by a malleolar vasculitic
skin lesion on the right leg.
Exuding, sloughty wound, nonvital margins and inflammed
perilesional skin. After wound
cleansing with saline solution,
Hyalogran® was applied in order
to remove the slough and
manage the exudate. A nonadherent gauze and cotton
bandages were used as
secondary dressing.
Dressing change every 4 days.
18
Case 4: malleolar vasculitic ulcer (II)
T 32 days: thanks to Hyalogran® a
granulating healthy wound bed was
obtained, which was decreasing in size
following re-epithelialization from edges.
Inflammation of perilesional skin was
undergoing resolution. As the
granulation process was well initiated, it
was decided to shif t towards
Hyalofill ® wound management, with
weekly dressing changes.
T 75 days: thanks to Hyalofill® a quick
re-epithelialization was gained with a
good quality in the neo-dermal tissue.
19
Case 5: inguinal diastasis following PTFE
patch revascularization (I)
68 year-old female diabetic patient
who underwent left femoral endoarterectomy
with a PTFE patch. The patient later developed a
diastasis at the surgical incision. The lesion was
cavitated and undermined. Initially it was treated
with a collagenase/HA cream daily, until fibrin
residues were gotten rid. After collagenase
treatment, the cavity wound was 2.2 cm deep,
with a very friable granulation tissue. Following
sharp debridement, Hyalogran® was initiated,
filling the cavity at 2/3 of its volume. A
polyurethane foam was used as secondary
dressing. Dressing change every two days.
T 36 days: good response to Hyalogran® with a
par tial gaining of the dermal quota.
Hyalogran® dressing changes every 4 days,
secondary dressing as above.
20
Case 5: inguinal diastasis following PTFE
patch revascularization (II)
T 85 days: undermining was reduced to 0.6 cm, a
consistent granulation tissue was developing.
Hyalogran® renewal every 4 days. Secondary
dressing as before.
T 99 days: cavity completely filled by a compact
neo-tissue, flat lesion with a clean wound bed. At
this point, it was decided to shift towards
Hyalofill® wound management in order to speed
up the re-epithelialization process. Hyalofill®
dressing change every 7 days, secondary
dressing as before. Wound closure was achieved
in 4 weeks (photo not available).
21
Case 6: venous leg ulcer (I)
81 year-old male diabetic patient
Affected by reumatoid arthritis with
arterial hypertension and chronic
venous insufficiency. The lesion was 3
month-old and no compressive
bandaging was used until then.
Sloughy wound , sharp but not vital
margins, perilesional skin was turgid
and redness.
Hyalogran® wound management was
decided to get rid of the fibrin slough,
to manage the exudate and to kickstart the healing process. Dressing
change every 4 days. A secondary
dressing composed of cotton pads and
adequate compressive bandage was
also applied
. 22
Case 6: venous leg ulcer (II)
Time 7 days: turgidity and redness of perilesional
skin undergoing resolution, as well as the fibrin
slough. A zinc-oxide paste was used to protect the
perilesional skin avoiding maceration and
controlling skin inflammation. After another
dressing change with Hyalogran® (dressing
change at 7 days), Hyalofill wound management
was decided, as the lesion was progressing well
towards re-epithelialization (compressive
bandaging always in place)
Time 45 days: following Hyalofill ® weekly
treatment, the wound is undergoing complete
resolution. Notice the extent of re-epithelialization
from wound edges due to the massive release of
HA from HYAFF®in situ degradation.
23
Case 7: trauma lesion on a phlebopathic
patient (I)
81 year-old male
Affected by chronic venous insufficiency
and lower limb chronic lynphatism
managed by compression bandaging.
Following a trauma, the patient developed
a large lesion on the right lower leg. The
lesion is exuding, partly graulating in some
areas and with fibrous material in others.
For this reason a combined Hyalogran®–
H y a l o f i l l ® t r e a t m e n t wa s d e c i d e d :
Hyalofill® on granulating areas,
Hyalogran® where fibrinous material was
present.
Compression bandaging to 40 – 45 mmHg
is associated.
Dressing change every 3 days.
. 24
Case 7: trauma lesion on a phlebopathic
patient (II)
T 14 days: the combine use of Hyalogran® and
Hyalofill resulted in a good stimulation of the
healing process. In the lower wound portion,
Hyalogran® allowed to get rid of fibrous slough
kick-starting the granulation process. In the
Hyalofill ® -treated area, a ver y fast reepitehlialization was observed. Wound edges were
not reddish nor swollen, but well-healthy and
pinkish. Hyalogran® was discontinued and the
lesion was managed only with Hyalofill®and
compression bandaging. Dressing change at 3
days.
T 21 days: lesion still quickly improving. Notice the
wound upper portion already healed, with a gapfilling effect exerted by Hyalofill®. Soft and pliable
tissue (which will help in preventing recurrences).
Dressing change at 7 days, compression
bandaging always in place.
25
Case 7: trauma lesion on a phlebopathic
patient (III)
T 60 days: excellent results at 2
months. The lesion is compeltely
closed, with a very good neo-dermis
regeneration. The tissue is soft,
pliable, with no evident scar
formation. This is due to the high
Hyaluronan content which stimulated
effectevely the wound healing
process.
26
HYAFF-based wound dressings
®
Hyalofill
Case Series ®
Hyalofill case 1: VCI in a bilateral gonarthrosis
patient
Fig 1 70 yr-old female patient, affected by arterious ipertension, VCI and
bilateral gonarthrosis. Acute multiple lesions on the right leg,
occured 20 days before. On Oct 26 the lesion was edematosus,
with macerated perilesional skin, irregular bottom and quite
exuding (fig 1). The wound was cleansed with saline and
disinfected with Amukine 0.05%, then Hyalofill® was applied as
primary dressing and the wound was dressed with an elastic
compressive bandage (medium strenght). Bi-weekly Hyalofill®
Fig 2 dressing change.
Fig 2 (Nov 2) The inner, larger lesion healed in one week time,
while the smaller and more eternal lesion had regained dermal
quota and was going to close. The edema was undergoing
improvement. After cleansing of teh lesion with saline, Hyalofill®
was reapplied along with compressive bendage (as above).
Dressing change twice a week
Fig 3 Fig 3 (Nov 27) A month later the lesion was completely reepithelialized. The neo-epithelium was protected by a polyurethan
film and a compressive garment was used in order to control
edema.
28
Hyalofill® case 2: severe vascular, necrotic
lesion in an ederly patient
Fig 1 Fig 2 80 yr-old female with a 14x8
cm necrotic vascular lesion on
the right leg.
Sloghty,
malodorant, secreting lesion
at day 0. The ulcer was
cleansed with saline solution
and Amukin 0.05%, then
necrotic tissue was removed
(by a collagenase cream) (Jan
14)
After necrotic tissue removal,
the lesion was presenting with
an acceptable wound bed, but
with irregular , macerated, not
well-vital margins, Hyalofill®
was then applied (Feb 1), with
dressing changes every 4 days.
A silver releasing HA cream
was also used in combination
with Hyalofill®.
29
After two months the lesion
was compeltely reepithelialized . (March 30).
The wound bed was of high
quality, the tissue was soft
and well-hydrated, also the
aesthetic outcome was very
satisfactory. Hyalofill® case 3: deep and large skin lesion
after radiotherapy in a pediatric patient
10 yr-old girl, presenting a large
skin ulcer following radiotherapy for
a brain tumor. Clean, dry lesion
with crosts mainly on margins. An
o c c l u s i ve d r e s s i n g
wo u n d
management was chosen (Dec 11)
At dressing removal the lesion was
worsened. Cleansing of the lelsion
with saline to remove dead tissue
and dressing remnants. Hyalofill®
was then applied (Dec 14)
After only 3 days re-epithelialization
is undergoing very fast. The neoepithelium is excellent in quality,
the effect of HA released by
Hyalofill ® is highly evident.
Hyalofill® was reapplied (Dec 17)
30
On Dec 21 the lesion was
completely closed.
Hyalofill® case 4 : deep vasculitic lesion on the
leg
68yr-old female patient,
presenting with a vasculitic lesion
on the leg , with vessel exposition.
The lesion was disinfected with
clhorexidrin, then Hyalofill® was
applied, combined with gauzes
i m p r e g n a te d w i t h a S i l ve r
releasing HA cream (Jun 5).
Dressing changes every week.
Excellent re-gaining of the dermal
quota only after 2 weeks, which
was induced by the HYAFF ®
action (Jun 30). Clean, granulating
wound bed, with wound margins
re-epithelialization undergoing
from margins. Hyalofill ® was
applied again (at weekly intervals)
until final healing
31
On Aug 30 the lesion was
completely closed.
®
Hyalofill case 5: deep vasculitic lesion on
Achilles region
70yr-old male patient, presenting with a
vasculitic lesion, quite complex depending on
the location. Moreover , patient’s relatives
could not take him regularly to the ambulatory
appointments. The lesion was clean, but with
irregular and not well-vital margins, Hyalofill®
was applied in association with a Silver
dresing, as the patient could come back only
after 15 days (Jun 23)
Marked improvement of the lesion, good
perilesional skin and re-epithelialization from
margins. Hyalofill® was applied again (July
21)
32
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Hyalofill case 5: deep vasculitic lesion on
Achilles region
Re-epithelialization almost complete, excellent
perilesional skin. Hyalofill ® was re-applied,
associated with Silver dressing to avoid infections
(Aug 4)
On Dec 13 the lesion was completely closed
33
®
Hyalofill case 6: VAC combined with
®
Hyalofill
74yr-old male patient, presenting with a severe wound
dehiscence following colon cancer removal, which required
a stoma. Soon after the surgery the patient was taken to ICU
due to serious complications. A multi-resistant Pseudomonas
Aeruginosa infection was found. It was decided to apply VAC
as the lesion was highly secreting and could not be managed
even with Aquacel AG (which required 3 dressing changes
per day, due to the massive exudate production). The lesion
is at full-thickness, with necrosis involving tissue planes,
even the animal-derived dermal substitute which had been
previously used. The patient was taken to the OR for a deep
surgical debridement. (T0)
All necrotic tissue and the dermal substitute remnants were
removed. Hyalofill® was applied combined with VAC, to
properly manage the exudate, to protect from infections and
to stimulate the wound healing process. Dressing changes
every 3 days (T0)
34
®
Hyalofill case 6: VAC combined with
®
Hyalofill
2 weeks later the wound bed is clean and wellgranulating, with vital margings undergoing
contraction by re-epithelialization. Hyalofill® was
continued in association with non-adherent
dressings. Dressing changes every 3 days
3 weeks from surgery: regular and clean wound bed
in marked contraction, vital margins, well adherent
and absolutely not undermined.the elsion will gain
final closure in 40 days time (in total) with Hyalofill®
changes from 3 to 7 days (in the later times).
35
Hyalofill® case 7: paraplegic patient
56 yr-old male, paraplegic (D9 level) is admitted to
the Spinal/ICU unit for severe respiratory problems .
The patients presents three, grade IV pressure
lesions on the sacral, right and lest ischiatic
regions . After a careful debridement, a VAC
treatment was applied for 5 months but with poor
results. Therefore it was decided to manage the
elsion with Hyalofill®, filling compeltely the cavities.
Dressing changes every week. (sacral and left
ischiatic lesions will be then considered). (June 1)
3 weeks later the lesions are considerably improved.
Fresh, clean granulating wound bed with regaining
of the dermal quota, healthy perilesional skin and
vital, re-epithelializing wound margins. Hyalofill®
was continued with weekly dressing changes. (June
20)
36
Hyalofill® case 7: paraplegic patient
At three months the sacrallesion was almost
completely closed, while the other showed an
excellent improving: clean and granulating wound
bed, marging undergoing re-epithelialization (Sept
18)
One month later the two lesions were compeltely
closed. Notice the eexcellent aestetic results,
meaning that the healed tissue was of a very good
quality. Hyalofill® contributed in the regeneration of
the dermal tissue, with newly deposition of collagen
fibers. (Oct 27)
37
HYAFF® Dressings
®
Hyalosafe 38
Hyalosafe®
Product description
§  Hyalosafe® is a bioactive, transparent film
wound dressing.
§  It is entirely composed of HYAFF® (total ester of
hyaluronan).
§  Hyalosafe® is designed to provide an effective
covering of superficial wounds.
Compared to traditional film dressings, Hyalosafe® does not exert only a mechanical role,
but it also actively interacts with the lesion environment, promoting the renewal of the
epithelium.
39
Hyalosafe®
Market presentation
- 3 dressings 10x15 cm
40
Hyalosafe®
Technical features
§  Hyalosafe® is sterilized by gamma
irradiation
§  The product is for single use only
§  Hyalosafe® must be stored at room
temperature (T<40°C)
§  Shelf-life: 4 years
41
Hyalosafe®
Technical characteristics
§  Its transparency allows a continuous
monitoring of the wound healing process
without removing the dressing.
§  It is permeable to aqueous vapour (its
w a t e r- v a p o u r t r a n s m i s s i o n r a t e i s
comparable to that of normal skin)
§  It is not permeable to microorganisms (test
performed on S. aureus and P. aeruginosa
under normal and stressed conditions)
42
Hyalosafe®
Indications
§  Donor sites
§  First and superficial second-degree burns
§  Superficial surgical wounds (i.e. after laser
resurfacing for facial rejuvenation or to
remove acne scars or pigmentation)
§  Moderately exuding wounds
Wound bed aspect
Without infection and at a slight level of
exudate.
43
Hyalosafe®
Mechanism of Action
As Hyalosafe® is applied directly on the lesion, it
keeps the wound moist, thus creating the ideal
conditions for a rapid re-epithelialization, avoiding
tissue maceration.
Compared to traditional film dressings, Hyalosafe®
does not exert only a mechanical role, but it also
actively
interacts with the lesion environment,
promoting the renewal of the epithelium.
WHEN to use it?
To promote re-epithelialization and protect the neo
epithelium.
44
Hyalosafe®
HOW to use it
A f te r p ro p e r l y c l e a n s i n g t h e wo u n d ,
Hyalosafe® is applied on the wound and
covered with a secondary dressing.
Hyalosafe® may be easily removed with
sterile forceps.
On dry wounds, the possibility does exist that
the dressing will dry out. In case of dressing
change Hyalosafe® may be re-hydrated with
saline before its removal (see also next slide)
45
Hyalosafe®
Frequency of dressing change
It depends on the nature and conditions of the
wound.
In surgical wounds (donor sites, laser ablation,
etc), generally the product is stuck on the
wound, in this case, DO NOT remove it, but let
it to detach spontaneously, along with the
natural re-epithelialization of the lesion.
46
Hyalosafe®
References
The treatment of face burns with Jaloskin
Merone A, Severino G, Capone C and
Saggiomo G. Annals Burns Fire Disasters,
2001;vol XIV, 4
47
HYAFF-based wound dressings
®
Hyalosafe
Case Series Hyalosafe® – Case Study
Second degree face burns
®
After 15 days’ tratment
After dressing wth Hyalosafe
(1 single application, Hyalosafe® left
in place for 15 days )
Merone A et al, Annals of Burns and fire Disasters- vol XIV-n4-Dec 2001
49
Superficial II degree burn: left side
•  28 year-old woman, supercial burn by flame.
•  Disinfection of the wounded area + application of Hyalosafe®
•  No dressing changes, healing in 21 days
50
Superficial II degree burn: right side
•  28 year-old woman, supercial burn by flame.
•  Disinfection of the wounded area + application of Hyalosafe®
•  No dressing changes, healing in 21 days
51
Clinical need: HEALING following skin
resurfacing
Laser CO2 HERBIUM Post OP
Swelling, for 2 wks
then redness,
itch and sensitivity
for months
Results
visible after months and
Dependent on
Post-OP care
52
Hyalosafe® in aesthetic medicine
Hyalosafe® IS BIO-INTERACTIVE
Thanks to the properties of Hyaluronic acid, it
speeds up the re-epitelialisation process and
improves the aesthetic outcome of the
treatment
• It is bio-compatible and bio-degradable
• It is permeable to GASES and water vapour
• Protects the wound bed from infection
• Its transparecy allows continuous monitoring
of the reparative process
53
Hyalosafe® selling message
Why Hyalosafe® in skin resurfacing
post-op care?
Because it allows for a quick reepithelialisation and an improved
epidermis quality thanks to HA
biological properties
54
Hyalosafe® Case study: acne removal
Prof. Giuliani, L’Aquila
55
®
Hyalosafe Case study: acne scars removal
Prof. Giuliani, L’Aquila
56
Hyalosafe® Case study: labial folds treatment
Prof. Giuliani, L’Aquila
Example of product positioning
57
®
Hyalosafe Case study: facial rejuvination & labial
folds treatment
Final outcome following Hyalosafe
wound management
Pre-laser treatment
58
Hyalosafe® - Case study: nevus laser ablation
Pre-treatment
C02 laser
Erbium after CO2
Jaloskin
Post Treatment
59
Hyalofill-F
Distribution:
§  Hospitals & wound care clinics
§  Home care
Hyalogran
Target users:
§  Plastic surgeons
§  Dermatologists
Hyalosafe
§  Diabetologists
§  Vascular surgeons
§  Nurses
®
Hyalosafe - Case 1: Loss of substance
following amputation
54 yr-old male patient, due to a
severe right leg artheropathy, a
d i s t a l fo ot a mp u t a t i o n wa s
deemed necessary. After 5 months
the lesion was still not closed. A
surgical debridement was
performed, inorder to remove all
dead tissue debris and revitalized
the wound margins, getting rid of
all callous tissue on borders. (Sept
21)
The next day Hyalosafe® was
applied, in association with
plateled gel. A n interesting
sinergy between HYAFF and GFs
of teh platelet gel has been seen.
The transparency of the film
makes the wound monitoring very
simple and easy. Weekly dressing
changes.(Sept 22)
61
Two month later the wound was
remarkably smaller, with a profound
re-epithelailization process ongoing. The lesion was going to be
closed soon after. (Nov 22)
®
Hyalosafe - Case 2: Loss of substance following
amputation
46 yr-old male patient, formerly drug
a b u s e r, I V C C 6 s t a g e :
medial
sovramalleolar right leg lesion resistant to
spontaneous re-epithelialization. On March
16 the elsion was 4x3 cm, clean, and
g ra n ul a ti n g wo u n d b e d
h ea l thy
®
perilesional skin. Hyalosafe was applied
with weekly dressing changes (March 16).
40 days later the lesion was completely reepithelialized, with excellent aesthetic
outcome. Notice the pinkish area which
resulted from the newly formed epithelium
(Apr 27).
62
®
Hyalosafe - Case 3: leg vasculopathic lesion
72 yr-old male vasculapathic patient with
a moderately exuding vascular lesion on
the tibial region. The wound bed was
fibrinotic, inflammed and presenting
infection signs. Non-vital and irregular
wound margins, iperemic and
edematousus perilesional skin. The
lesion was cleansed with saline and a
sulfadiazine-HA cream was applied.twicw
a week on a home-care basis. .
14 days later inflammation and infection
were under control, therefore Hyalosafe
was applied. Two weekly dressing
changes, then Hyalosafe® was kept on
teh wound for 10 days.
63
At 40 days the lesion was
healed, thanks to the reepithelialization stimulated by
the HA release and by the
mechanical protection of
Hyalosafe®.
Hyalosafe® - Case 4: post-traumatic lesion in
a diabetic patient
55 yr-old diabetic male patient, with a previous cardioapathic
ischaemy and arterial ipertension presenting a pressure
ulcer on the site of a previous (35 years before) traumatic
partial popliteal muscles ablation due to a rotating saw. The
soft tissue loss has been treated with autologous chineseskin autografts. The lesion appeared 8 months before and
had been managed with traditional dressings since them ,
without success. The patient refers heavy, continuos and
pulsing pain. Deambulation was possible with stamps.
The lesion was exudin as Staphilococcus and Pseudomonas
strains were found, margins were callousus and undermined,
necrotic wound bed with a clear loss of substance. Stasis
dermatitis on perilesional skin. Cleansing with ringer lactate
solution and disinfection with Prontosan, thena silver
nanocrystal dressing and polyurethane sponge-to manage
the exudate- were applied, along with sistemic antibiotic
therapy for 10 days. Dressing change every 3 days (Feb 23).
64
®
Hyalosafe - Case 4: post-traumatic lesion in a
diabetic patient
Biobrane was applied on
March 3, to stimulate the
granulation tissue formation,
but it was judged not enought
therefore on March 13
Hyalofill ® was applied to
regain the dermal quota.
Dressing change at weekly
inter vals. Since then the
patient did not report any
further again.
On Apr 4 the wound bed was
freshly granulating, vital
margins and wound
contraction due to reepithelialization. Healthy
perilesional skin, only minor
exudate (a small portion of the
tendon is still visible).
Hyalosafe® was applied to
enhance reepithelialization
and to monitor easily the
h e a l i n g p ro c e s s . We e k l y
dressing changes.
65
On May 29 the lesion was 99% reepithelialized, still no reported
pain . It took less than 2 and a half
months to get to this point.
Hyaluronic Acid-based
Advanced Wound Care Products
Thank you for your kind attention