Open AccessStudies in Fetal Wound Healing V. A Prolonged Presence of Hyaluronic Acid Characterizes Fetal Wound Fluid
Author(s) -
Michael T. Longaker,
E. Chiu,
N. Scott Adzick,
Michael D. Stern,
Michael R. Harrison,
Robert Stern
Publication year - 1991
Publication title -
annals of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.153
H-Index - 309
eISSN - 1528-1140
pISSN - 0003-4932
DOI - 10.1097/00000658-199104000-00003
Subject(s) - hyaluronic acid , wound healing , medicine , extracellular matrix , fetus , fibroblast , fibrosis , andrology , pathology , surgery , microbiology and biotechnology , anatomy , pregnancy , biochemistry , in vitro , biology , genetics
Midgestation fetal wound healing is characterized by healing without fibrosis or scar formation. The mechanisms that underlie this remarkable process are mediated in part through a fetal wound extracellular matrix rich in hyaluronic acid. In this study a newly developed assay was used to determine the hyaluronic acid levels in fetal and adult wound fluid. Adult wound fluid had a rapid increase in hyaluronic acid, which peaked at 3 days and decreased to 0 by 7 days. In contrast levels of hyaluronic acid in fetal wound fluid increased rapidly and remained significantly elevated for 3 weeks. This prolonged presence of hyaluronic acid in the matrix of fetal wounds creates a 'permissive' wound environment that promotes fetal fibroblast movement and proliferation and inhibits cytodifferentiation. Such a matrix environment promotes healing by regeneration rather than by scarring. This observation has therapeutic implications. The prolonged application of hyaluronic acid or hyaluronate protein complexes to wounds in children or adults may modulate healing in a manner that makes the wounds more fetal-like.