Hyaluronic Acid-Based Products Are Strictly Contraindicated in Scleroderma-Related Skin Ulcers

Giulio Gualdi, MD; Paola Monari, MD; Daniele Cammalleri, MD; Laura Pelizzari, MD; Piergiacomo Calzavara Pinton, PhD


Wounds. 2019;31(3):81-84. 

In This Article

Materials and Methods

A retrospective case review was conducted on 106 chronic wounds of various etiologies (vascular, scleroderma, and postoperative) with granulating appearance unresponsive to common topical wound dressings (alginates-carboxymethylcellulose, hydrogel, polyurethane foam, collagen). A total of 79 patients (55 women, 24 men) were enrolled with a mean age of 71 years (range, 40–98 years). The 79 patients and relative 106 skin ulcers were divided in 2 groups: nonsclerodermic and sclerodermic (Table 1). Ulcers of neoplastic origin, iatrogenic ulcers, diabetic ulcers, and ulcers of recent onset (< 6 weeks) were excluded from the data source. In addition, ulcers for which HA is not indicated (infected ulcers and ulcers covered with necrotic tissue) were excluded from the study. The HA-based products used included Ialuset cream (300 kDa; IBSA Farmaceutici Italia, Lodi, Italy), Hyalofill-F (400 kDa; Fidia Farmaceutici s.p.a., Abano Terme, Padua, Italy), and Bionect Start (160 kDA; Fidia Farmaceutici s.p.a.). The products were applied according to the manufacturer's package insert.