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.