Avant-propos.

Hard-to-heal wounds are a problem for both patients and caregivers. The biofi lm is one of the local factors of delayed healing. Wound hygiene carried out in 4 steps (cleansing, debridement, refashion - care of the edges, and dressing) constitutes the basis of proactive and curative anti-biofi lm strategies.

Efficacy and safety of hyaluronic acid in the management of acute wounds.

INTRODUCTION: Hyaluronic acid (hyaluronan) is a key component of the extracellular matrix and is known to be involved in several mechanisms of the wound healing process. It has been shown to improve and accelerate the healing process of chronic wounds. This open-label study investigated whether application of hyaluronic acid could also improve the healing progression of acute wounds. METHODS: Forty-three patients with acute wounds, including trauma wounds, surgical sutures, burns, and dermabrasions, were included in the study. Hyaluronic acid (ialuset) was applied either as a cream or as a dressing, and the progression and quality of healing were evaluated at each application for a maximum of nine applications. RESULTS: The mean surface area of the wounds decreased from 556 mm(2) at baseline to 169 mm(2) by the sixth evaluation, an average reduction of 70% in the surface area of the wounds. Complete healing occurred in 56% of cases by the sixth application. Little or no fibrin was observed in 91% of cases, and 84% of wounds showed little or no exudate. Both formulations of hyaluronic acid were well tolerated and were rated highly by nurses and patients for ease of use and treatment satisfaction. CONCLUSION: Interpretation of the results of this open-label study is limited by the lack of a standard wound dressing as a comparator and by the varying types of wounds selected for inclusion. Nevertheless, the results of this study indicate that hyaluronic acid provides good healing of acute wounds and is well accepted by both patients and nurses.