Topical oxygen therapy with hyaluronic acid improves wound healing in small animals

Objective To evaluate the effectiveness of topical oxygen therapy (TOT), with and without hyaluronic acid (HA), in improving the healing process of open wounds in dogs and cats. Methods This prospective, single-blind, randomized study was conducted from 2020 to 2023. Open wounds ≤ 15 cm2 were randomly assigned to 3 groups according to the treatment applied: the TOT group, TOT+HA group, and control group. Total oxygen therapy was delivered at 5 L/min for 10-minute sessions directly on the wound bed, with or without 1 mL of nebulized 0.2% low-molecular-weight hyaluronate, every 3 to 5 days until complete wound healing. The control group underwent standard-of-care treatment with honey and bandages, as in the other 2 groups. Wounds were evaluated at different time points by a single blinded surgeon using the Bates-Jensen Wound Assessment Tool (BWAT), with lower scores indicating improved wound healing. Results 46 open wounds in 34 dogs and 8 cats were included. Wounds treated with TOT+HA presented a significantly lower total BWAT score than the other groups at 21 days. Considering every variable of the BWAT, a statistically significant difference was found for epithelialization and area at 7 days and for edges, granulation tissue, and epithelialization at 21 days, with a significantly lower score in wounds treated with TOT+HA. Conclusions Wounds treated with adjuvant TOT+HA resulted in significantly improved and faster healing compared with standard dressings at 21 days. Clinical Relevance The use of adjuvant therapy with TOT+HA has proved to be safe, effective, and easy to apply in the management of open wounds.