The Effectiveness of Amniotic Membrane as Skin Graft Fixator and Graft Take Accelerator, a Clinical Research Study

Dana A Abdilkarim; Ari Raheem Qader; Abdulsalaam M. Yonis

doi:10.24017/science.2016.1.1.8

Authors

Dana A Abdilkarim Department of Community Health, Sulaimani Polytechnic University, Sulaimani, Kurdistan Region, Iraq
Ari Raheem Qader Department of Surgery, University of Sulaimani, Sulaimani, Kurdistan Region, Iraq.
Abdulsalaam M. Yonis Department of Health, General Directorate of Health, Mosul, Iraq

Abstract

The amnion is a thin semi-transparent tissue forming the innermost layer of the fetal membrane. It has been claimed to be one of the most effective biological skin substitutes used in burn wounds, with efficiency of maintaining low bacteria count.This study was set to evaluate the effectiveness of amniotic membrane as skin graft fixator and graft take accelerator.This work is a prospective study carried out in Burns and Plastic Surgery Hospital in Sulaimani for period from 1st of April to end of August 2015 on convenient sample of 33 burned patients.Mean age of burned patients was 24±19 years, Most (93.9%) of burned patients were treated by covering raw area with meshed SSG and only two patients were treated by covering with sheet SSG. Most (90.9%) of burned patients who had treated with covered SSG had taken in comparison with non-covered SSG with amniotic membrane. Postoperative complications for skin areas treated with covered technique were 3; graft loss due to infection, graft loss due to shearing and graft loss due to hematoma.Amniotic membrane induces the graft take among burned skin and fastening the skin healing with fewer complications.

Keywords:

Graft take, Amniotic membrane, Biologic Dressing, Split Skin Graft (SSG)

References

[1] Halim AS, Khoo TL, Mohd. Yussof SJ (2010).Biologic and synthetic skin substitutes: An overview. Indian Journal of Plastic Surgery. 43(l):S23-S28.
https://doi.org/10.1055/s-0039-1699458
[2] Bujang-Safawi E, Halim AS, Khoo TL, Dorai AA (2010). Dried irradiated human amniotic membrane as a biological dressing for facial burns: A 7-year case series. Burns. 36:876-82.
https://doi.org/10.1016/j.burns.2009.07.001
[3] Sangwan VS, Burman S, Tejwani S, Mahesh SP, Murthy R (2007). Amniotic membrane transplantation: a review of current indications in the management of ophthalmic disorders. Indian J Ophthalmol. 55(4):251-60.
https://doi.org/10.4103/0301-4738.33036
[4] Rudge R (2007). An easy and safe method of split- thickness skin graft fixation. Burns. 33:1074-5. Alexander G, Al-Rasheed AA (2005). Skin stapler removal by artery forceps: a hazardous practice? Burns. 31:116.
https://doi.org/10.1016/j.burns.2007.03.027
[5] Mohammadi AA, Ghoddusi johari H (2009).Forgotten staples. Burns.35: 611.
https://doi.org/10.1016/j.burns.2008.08.005
[6] Ilteris Murat E (2007). A different and safe method of split thickness skin graft fixation: medical honey application. Burns. 33:782-7.
https://doi.org/10.1016/j.burns.2006.12.005
[7] Adler N, Nachumovsky S, Meshulam-Derazon S, Ad-El D (2007). Skin graft fixation with cyanoacrylate tissue adhesive in burn patients. Burns. 33:803.
https://doi.org/10.1016/j.burns.2006.12.006
[8] Mohammadi AA, Ghoddusi Johari H (2008).Amniotic membrane: A skin graft fixator convenient for both patient and surgeon. Burns. 34:1051-1052.
https://doi.org/10.1016/j.burns.2008.02.004
[9] Mohammadi AA, Ghoddusi Johari H (2010).Anchoring sutures: useful adjuncts for amniotic membrane for skin graft fixation in extensive burns and near the joints. Burns. 36:1134-1141.
https://doi.org/10.1016/j.burns.2009.05.015
[10] Antasov W, Mazalova J, Todorod R, Stereva K, Trencheva W (1994). Use of amniotic membrane as biological dressing in contemporary treatment of burn. Ann Medit Burns Club. 7:202-5.
[11] Kesting MR, Loeffelbein DJ, Classen M, Slotta- Huspenina J, Hasler RJ, Jacobsen F, et al (2010). Repair of oronasal ? stulas with human amniotic membrane in minipigs. Br J Oral Maxillofac Surg. 48:131-5.
https://doi.org/10.1016/j.bjoms.2009.04.025
[11] Singh R, Chacharkar MP (2011). Dried gamma- irradiated amniotic membrane as dressing in burn wound care. J Tissue Viability. 20:49-54.
https://doi.org/10.1016/j.jtv.2010.06.001
[12] Chopra A, Thomas BS (2013). Amniotic membrane, A Novel Material for Regeneration and Repair. J Biomim Biomater Tissue Eng. 18:1-8.
[13] Kim SS, Song CK, Shon SK, Lee KY, Kim CH, Lee MJ, et al (2009). Effects of human amniotic membrane grafts combined with marrow mesenchymal stem cells on healing of full- thickness skin defects in rabbits. Cell Tissue Res. 336:59-66.
https://doi.org/10.1007/s00441-009-0766-1
[14] Ganatra MA, Bhura S (2004). Management of skin graft donor site by irradiated amniotic membrane. Pakistan Journal of Surgery. 19 (2): 82-85.
[15] Kumar A, Chandra V, Reddy AA, Reddy BH, Reddy C, Naveen A (2015). Evaluation of clinical, anti-in?ammatory and anti-infective properties of amniotic membrane used for guided tissue regeneration: A randomized controlled trial. Surgical Research Journal. 12 (2): 127-135.
[16] Gonce S, Miskell P, Waymack JP (1990). A comparison of biobrane vs homograft for coverage of contaminated burn wounds. Burns. 14: 409-412.
https://doi.org/10.1016/0305-4179(88)90013-7
[17] Kearney J (1996). Banking of skin grafts and biological dressing. In: "Principle and practice of burns management", John A.D. Settle (ed.), Churchill Livingstone, New York, 329-51.