Hyaluronic acid in incision wound fluid: a clinical study with the Cellstick device in children.
When inserted into a human incision wound, the Cellstick device harvests inflammatory cells and collects wound fluid, reflecting time-related changes in cell populations and in wound fluid composition. Hyaluronic acid has been postulated to be an important factor in scar reduction in wound healing and in scarless fetal wound healing. The aim of this work was to determine the concentration and variation of hyaluronic acid and proportions of wound cells in closed surgical wounds in children at two time points. The Cellstick device was inserted subcutaneously into the wound at the end of an elective inguinal hernia operation on 37 healthy boys, and the devices were removed 3+/-1 or 24+/-3 hours after surgery. Haluronic acid concentration was measured from the wound fluid and a differential count of the wound cells was performed. There was a significant decrease in hyaluronic acid concentration from 3+/-1 to 24+/-3 hours after surgery (p<0.001, Kruskal-Wallis anova). The variance of hyaluronic acid concentration in wound fluid differed between the wounds at the two time points (p<0.01, Levene test for homogeneity of variance). A positive correlation between hyaluronic acid concentration and patient age (r=0.91, p<0.05, Spearman) at 3+/-1 hours post surgery and between HA and wound lymphocytes (r=0.38, p<0.05, Spearman) was also found. We conclude that the hyaluronic acid concentration in wound fluid peaks early in children and decreases significantly by 3 to 24 hours after surgery, and the concentrations in the wound fluid of healthy boys are more variable 3 hours than at 24 hours after surgery.
Pajulo
O T
OT
Department of Paediatric Surgery, Turku University Central Hospital, Turku, Finland. olli..pajulo@utu.fi
Pulkki
K J
KJ
Lertola
K K
KK
Alanen
M S
MS
Reunanen
M S
MS
Virtanen
R V
RV
Mattila-Vuori
A I
AI
Viljanto
J A
JA
D000704:Analysis of Variance; D002452:Cell Count; D002648:Child; D002675:Child, Preschool; D005122:Exudates and Transudates / Q000737:chemistry* / Q000276:immunology; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D006820:Hyaluronic Acid / Q000032:analysis* / Q000502:physiology; D007223:Infant; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D009504:Neutrophils; D013048:Specimen Handling / Q000295:instrumentation*; D018709:Statistics, Nonparametric; D013997:Time Factors; D014945:Wound Healing; D014947:Wounds and Injuries / Q000209:etiology / Q000276:immunology / Q000473:pathology*
D006820:Hyaluronic Acid