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

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.