Background: Hyaluronic acid (HA) has a key role in all stages of the wound healing process. In recent years different specialties have begun to make use of HA to prevent the development of scarred adhesions after surgery
Materials, and Methods: We report the case of a challenging wound revision surgery in the anterior triangle of the neck in a 69-year-old female patient. A novel method with intra and postoperative HA injection was used to treat massive and impairing cervical adhesions after multiple neck surgeries, such as a tracheostomy and previous unsuccessful revision surgeries. Before our surgery, the patient complained about hoarseness, swallowing difficulties and neck tightness.
A wound revision surgery was performed in local anaesthesia. 1 ml of HA was injected intraoperatively in the form of two depots (subcutaneous and submuscular). On the 14th postoperative day injection of additional 0,4 ml HA as a subcutaneous depot was performed.
Results At her final follow-up appointment, 8 weeks after surgery the patient reported on her voice being normal, in addition, swallowing was possible without difficulty and her hoarseness had resolved. She had resumed normal activity and had no complaints.
Discussion HA appears to contribute to the prevention of adhesions after surgery. Most existing studies have reported effects preventing granulation and scarring; however, this case is significant as, to our knowledge, it is the first report of use of HA for this purpose in neck surgery. Although this case showed good postoperative results, the evidence is still limited and further studies need to be developed in order to provide a consistent and evidence-based method to prevent postoperative adhesions in neck surgery.
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