A CONTROLLED-STUDY OF THE ACTIVITY OF HYALURONIC-ACID IN THE TREATMENT OF VENOUS LEG ULCERS

In slow-healing wounds, i,e, those with little granulation tissue with deep necrotic tissue and exudation, complicated by inflammation, ther e is depolymerization and degradation of local mucopolysaccharides, es pecially hyaluronic acid, A local deficit of hyaluronic acid leads to insufficient regeneration of connective tissue, poor angiogenesis and deficient differentiation of histiocyte and fibroblast populations, Ex ogenous hyaluronic acid applied to a debrided wound keeps it moist and ensures a high concentration at the site of action, Hyaluronic acid s tabilizes the clot matrix, attracts inflammatory, mesenchymal and epit helial cells into the wound area and enhances angiogenesis of the clot tissue, It also exerts an antiexudative, vasoprotective and fibrogeni c action in inflamed tissues of slow-healing wounds, In this multicent re controlled study we evaluated the efficacy and safety of hyaluronic acid in 50 patients with venous leg ulcers in comparison with Dextran omer, the product of choice for this indication in France, Objective p arameters, including the appearance and dimensions of the ulcer, impro ved significantly in both treatment groups, However, there was a faste r and greater reduction in the ulcer dimensions following treatment wi th hyaluronic acid, Both treatments improved surrounding erythema, pai n, oozing and necrosis but only hyaluronic acid caused a significant d ecrease in oedema, A greater number of positive efficacy judgements we re seen in the hyaluronic acid group, The local tolerability of the tw o treatments was excellent, Hyaluronic acid is therefore a safe and ef fective treatment for patients with venous leg ulcers.