Studies in fetal wound healing: V. a prolonged presence of hyaluronic acid characterizes fetal wound fluid

The adult wound healing process is characterized by the formation of fibrotic scar tissue and sometimes contracture of tissue around the wound. This process affects all types of surgery and may have serious consequences. However, wound healing in a fetus does not, for the most part, result in fibrosis or scar formation. The transition from fetal to adult type of wound healing occurs in the middle of last trimester of pregnancy. Fetal wound healing is brought about partly through an extracellular matrix rich in hyaluronic acid, a substance found whenever there is rapid cell development and movement. It is hypothesized that a wound extracellular matrix rich in hyaluronic acid provides an environment in which a wound can heal without scar tissue forming. A study was undertaken to evaluate the levels of hyaluronic acid in fetal and adult wound fluid. Adult wounds show a rapid increase in hyaluronic acid, which peaked by day three and was 0 by day seven. In the fetal wound, the hyaluronic acid level also increased rapidly, but remained elevated for three weeks. This long period of exposure to hyaluronic acid promotes cell movement and inhibits cell differentiation; healing occurs by regeneration of tissue, rather than by scarring. This finding may have major clinical implications. It may be possible that wound healing in adults and children can be induced into a regeneration process, similar to that which takes in the fetus, by prolonged exposure to hyaluronic acid. (Consumer Summary produced by Reliance Medical Information, Inc.)