# Injectable Hyaluronic Acid and Amino Acids Complex for Pediatric Hard-to-Heal Wounds: A Prospective Case Series and Therapeutic Protocol

## TL;DR

A new injectable treatment combining hyaluronic acid and amino acids shows promise in healing chronic wounds in children quickly and safely.

## Contribution

An injectable hyaluronic acid and amino acid complex is proposed as a novel therapy for pediatric hard-to-heal wounds.

## Key findings

- Complete re-epithelialization was achieved in most patients within six weeks.
- Pain from chronic wounds was reduced or eliminated after two injections.
- No serious adverse events were observed during treatment or follow-up.

## Abstract

What are the main findings?
Complex soft-tissue injuries in pediatric patients, which may delay healing beyond six months due to a recalcitrant, chronic, or stalled wound, can be effectively treated with an injectable therapy combining hyaluronic acid and six amino acids in a single formulation. Regardless of the etiopathogenesis, the results allow for tissue repair and regeneration up to complete re-epithelialization.

Complex soft-tissue injuries in pediatric patients, which may delay healing beyond six months due to a recalcitrant, chronic, or stalled wound, can be effectively treated with an injectable therapy combining hyaluronic acid and six amino acids in a single formulation. Regardless of the etiopathogenesis, the results allow for tissue repair and regeneration up to complete re-epithelialization.

What is the implication of the main finding?
The results obtained, with no pain caused by the therapy itself, show a reduction and disappearance of pain from the chronic condition after just the first two injections, and complete repair of the complex lesion within a maximum of six weeks from the start of treatment. A six-month follow-up confirms stable outcomes with no relapse.

The results obtained, with no pain caused by the therapy itself, show a reduction and disappearance of pain from the chronic condition after just the first two injections, and complete repair of the complex lesion within a maximum of six weeks from the start of treatment. A six-month follow-up confirms stable outcomes with no relapse.

Background: Pediatric hard-to-heal wounds are rare but clinically demanding due to skin immaturity, comorbidities, and infection risk. Methods: This prospective case series evaluated the feasibility, safety, and clinical outcomes of an injectable hyaluronic acid-amino acid complex administered to fifteen children and adolescents (aged 4–16 years) with chronic hard-to-heal wounds, treated between November 2022 and August 2025 within a standardized wound-hygiene protocol. The primary outcome was time to complete re-epithelialization; secondary outcomes included pain, tolerability, and safety. Results: Complete healing was achieved in most patients within a few weeks of treatment. The injectable therapy was well tolerated, with minimal discomfort and no serious adverse events observed. Conclusions: The injectable hyaluronic acid-amino acid complex appears to be a safe, feasible, and potentially effective therapy for pediatric hard-to-heal wounds. These preliminary findings support its integration into multidisciplinary wound-care strategies, although controlled multicenter studies are warranted to confirm efficacy and define optimal protocols.