Ann Surg Treat Res.  2024 Feb;106(2):85-92. 10.4174/astr.2024.106.2.85.

Accelerated wound healing after topical application of hyaluronic acid cotton to hemorrhoidectomy wounds in a rat model

• Suh JW
• Lee MH
• Oh HK
• Kim HK
• Kweon DK
• Lee J
• Ahn Hm
• Kim DW
• Kang SB

• KMID: 2552389
• DOI: http://doi.org/10.4174/astr.2024.106.2.85

Abstract

Purpose
Anal wounds following hemorrhoidectomy can lead to severe pain and postoperative bleeding, impacting patient recovery and quality of life. Hyaluronic acid (HA) stimulates tissue regeneration and wound healing by accelerating cell migration and proliferation. This study aimed to investigate the differences in wound healing rate and completeness of recovery of perianal wounds topically treated with HA-soaked cotton in a murine model.
Methods
Forty-eight 8-week-old Sprague-Dawley rats with perianal wounds created using a biopsy punch were divided into 2 groups: simple dressing with gauze (control) and topical HA-soaked cotton. A single application of HA-soaked cotton was administered after surgery. Wound healing rate and completeness of recovery were evaluated by measuring the healed area and conducting histological analyses.
Results
The HA-cotton group exhibited a shorter complete wound healing duration compared to the control group (13.9 days vs. 16.4 days, P = 0.031). Differences in wound healing area between the 2 groups were greatest on postoperative day 2 (51.6% vs. 28.8%, P < 0.001). The HA-cotton group exhibited fewer cases of granulation tissue (2 vs. 5) or redness (0 vs.3) upon complete wound healing. Histologically, the HA-cotton group showed accelerated reepithelialization, rapid shift to lymphocyte-dominant inflammation, enhanced fibroblast proliferation, and increased collagen deposition compared to the control group.
Conclusion
Herein, topical application of HA-soaked cotton on perianal wounds in rats resulted in accelerated wound healing, particularly in the initial stages, and improved completeness of recovery, underscoring the potential of the topical application of HA-soaked cotton on hemorrhoidectomy wounds in human patients to improve wound healing.

Keyword

Hemorrhoidectomy; Hyaluronic acid cotton; Rat model; Wounds and injuries

Figure

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  Fig. 1 Hyaluronic acid cotton used in the present study.

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  Fig. 2 Visualization of the wound recovery process. Gross appearance of a perianal wound at various stages of healing. (A) Hyaluronic acid cotton group. (B) Control group.

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  Fig. 3 Comparison of recovery rate between hyaluronic acid cotton and control groups up to postoperative day 21.

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  Fig. 4 Histopathologic findings (H&E, ×100). (A) Hyaluronic acid cotton apply group. (B) Control group.

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