Hyaluronic Acid as a Treatment Option for Pressure Ulcers

Javier Ramos-Torrecillas, PhD; Elvira De Luna-Bertos, PhD; Lourdes Díaz-Rodríguez, PhD; Olga García-Martínez, PhD; Laura Rodríguez-Pérez, RN; Concepción Ruiz, PhD


Wounds. 2013;25(12):328-332. 

In This Article

Abstract and Introduction


Introduction. Health care professionals are constantly seeking novel approaches to treat pressure ulcers because of the impact they have on patient quality of life and health, as well as the costs associated with treating them.

Methods. A review of the literature from 2002–2012 was conducted on the clinical usefulness of hyaluronic acid in tissue regeneration. Reports suggest that the therapeutic use of hyaluronic acid favors tissue regeneration by modulating the hydration and osmotic balance.

Results. Different studies show that hyaluronan and derived-hyaluronic acid products are safe and free of adverse effects. Furthermore, a few studies examine the hyaluronic acids repercussions in pressure ulcer treatment.

Conclusion. Reports suggest that this molecule could be successfully used to treat pressure ulcers in association with conventional measures.


Pressure ulcers (PUs) are skin lesions that may involve the epidermis and deeper layers of the skin, sometimes even causing damage to muscle or bone. Triggering factors include an increase in capillary pressure at skin level as a consequence of the action of 2 opposing forces, as in the case of pressure on a bone protuberance.[1] Pressure ulcers compromise the health and quality of life of patients and entail high economic costs. Patients with a single PU are 3.5 to 5 times more likely to stay in the hospital than patients without an ulcer, and the development of novel approaches is of great interest to health care professionals, especially the nurses, who often treat them.[2]

Pressure ulcers are currently treated with a moist environment, which high-level evidence has proved effective in reducing healing time.[3] Hyaluronic acid is one of a group of molecules proposed to participate in the pathophysiological mechanisms underlying wound healing.[4] More recent studies have shown that treatment with hyaluronic acids and their derivatives have an important role in the regeneration of various tissues, such as periodontal, bone, adipose, or cartilage regeneration.[5–7]

The objective of this study was to review published reports on the clinical usefulness of hyaluronic acid in tissue regeneration and PU healing.