Studies in Fetal Wound Healing. V. A Prolonged Presence of Hyaluronic Acid Characterizes Fetal Wound Fluid

Overview

Journal Ann Surg

Specialty General Surgery

Date 1991 Apr 1

PMID 2009010

Citations 76

Authors

M T Longaker

E S Chiu

N S Adzick

M Stern

M R Harrison

R Stern

Affiliations

Soon will be listed here.

Abstract

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.

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References

Kistler A, Utsugi R, Ihara S . Wound healing in fetal limb organ culture. Ann Plast Surg. 1988; 21(4):303-9. DOI: 10.1097/00000637-198810000-00002. View

Harrison M, Langer J, Adzick N, Golbus M, Filly R, Anderson R . Correction of congenital diaphragmatic hernia in utero, V. Initial clinical experience. J Pediatr Surg. 1990; 25(1):47-55; discussion 56-7. DOI: 10.1016/s0022-3468(05)80163-0. View

Hellstrom S, Laurent C . Hyaluronan and healing of tympanic membrane perforations. An experimental study. Acta Otolaryngol Suppl. 1987; 442:54-61. DOI: 10.3109/00016488709102840. View

Krummel T, Nelson J, Diegelmann R, Lindblad W, SALZBERG A, Greenfield L . Fetal response to injury in the rabbit. J Pediatr Surg. 1987; 22(7):640-4. DOI: 10.1016/s0022-3468(87)80117-3. View

Thomas S, Jones L, Hungerford D . Hyaluronic acid and its effect on postoperative adhesions in the rabbit flexor tendon. A preliminary look. Clin Orthop Relat Res. 1986; (206):281-9. View

Scott J, Hughes E . Proteoglycan-collagen relationships in developing chick and bovine tendons. Influence of the physiological environment. Connect Tissue Res. 1986; 14(4):267-78. DOI: 10.3109/03008208609017470. View

Adzick N, Harrison M, Glick P, Beckstead J, Villa R, Scheuenstuhl H . Comparison of fetal, newborn, and adult wound healing by histologic, enzyme-histochemical, and hydroxyproline determinations. J Pediatr Surg. 1985; 20(4):315-9. DOI: 10.1016/s0022-3468(85)80210-4. View

Hallock G . In utero cleft lip repair in A/J mice. Plast Reconstr Surg. 1985; 75(6):785-90. DOI: 10.1097/00006534-198506000-00001. View

Rowsell A . The intra-uterine healing of foetal muscle wounds: experimental study in the rat. Br J Plast Surg. 1984; 37(4):635-42. DOI: 10.1016/0007-1226(84)90166-8. View

10.

Abatangelo G, Martelli M, Vecchia P . Healing of hyaluronic acid-enriched wounds: histological observations. J Surg Res. 1983; 35(5):410-6. DOI: 10.1016/0022-4804(83)90030-6. View

11.

Kujawa M, Tepperman K . Culturing chick muscle cells on glycosaminoglycan substrates: attachment and differentiation. Dev Biol. 1983; 99(2):277-86. DOI: 10.1016/0012-1606(83)90277-4. View

12.

Robinson B, Goss A . Intra-uterine healing of fetal rat cheek wounds. Cleft Palate J. 1981; 18(4):251-5. View

13.

Tengblad A . Affinity chromatography on immobilized hyaluronate and its application to the isolation of hyaluronate binding properties from cartilage. Biochim Biophys Acta. 1979; 578(2):281-9. DOI: 10.1016/0005-2795(79)90158-2. View

14.

Hunt T, Twomey P, Zederfeldt B, Dunphy J . Respiratory gas tensions and pH in healing wounds. Am J Surg. 1967; 114(2):302-7. DOI: 10.1016/0002-9610(67)90388-1. View

15.

Goss A . Intra-uterine healing of fetal rat oral mucosal, skin and cartilage wounds. J Oral Pathol. 1977; 6(1):35-43. DOI: 10.1111/j.1600-0714.1977.tb01792.x. View

16.

Harrison M, Jester J, Ross N . Correction of congenital diaphragmatic hernia in utero. I. The model: intrathoracic balloon produces fatal pulmonary hypoplasia. Surgery. 1980; 88(1):174-82. View

17.

Glanville R . A comparison of models for the macromolecular structure of interstitial and basement membrane collagens. Arzneimittelforschung. 1982; 32(10a):1353-7. View

18.

SCHILLING J, Joel W, SHURLEY H . Wound healing: a comparative study of the histochemical changes in granulation tissue contained in stainless steel wire mesh and polyvinyl sponge cylinders. Surgery. 1959; 46:702-10. View

19.

Longaker M, Adzick N, Hall J, Stair S, Crombleholme T, Duncan B . Studies in fetal wound healing, VII. Fetal wound healing may be modulated by hyaluronic acid stimulating activity in amniotic fluid. J Pediatr Surg. 1990; 25(4):430-3. DOI: 10.1016/0022-3468(90)90387-o. View

20.

Longaker M, Whitby D, Adzick N, Crombleholme T, Langer J, Duncan B . Studies in fetal wound healing, VI. Second and early third trimester fetal wounds demonstrate rapid collagen deposition without scar formation. J Pediatr Surg. 1990; 25(1):63-8; discussion 68-9. DOI: 10.1016/s0022-3468(05)80165-4. View