Using Dehydrated Amniotic Membrane Skin Substitute in Facial Burns: Is There a Outcome Difference Between Adult and Pediatric Patients?

Abstract

Introduction: Facial burns have significant physical and psychological effects on patients, and minimizing morbidity continues to be a challenge for reconstructive surgeons. Advancements have allowed the development of various skin substitutes. Among these, human dehydrated amniotic skin substitutes represent novel technology, yet their outcome has not been sufficiently studied to guide practice. The objective of our study is to compare the safety of amniotic membrane skin substitutes in the treatment of adult and pediatric facial burns. Methods: The authors performed a retrospective review of our institutional burn registry, with 90 burn patients meeting the inclusion criteria. Demographic and outcome measures included age, percentage of total body surface area (TBSA), Injury Severity Score (ISS), and complications (eg, pigmentation, hypertrophic scar, infection, and delayed healing). Paired sample t test and Chi-squared test were used, with significance defined as P < 0.05. Results: Seventy-seven adults and 13 pediatric patients with facial burns who had received dehydrated amniotic membrane skin substitutes were included in the analysis. The mean age was 40.8 years for adults and 5.6 years for children. Mean TBSA was similar, with 9.6% (1−57%) in adults and 6.0% (2−14%) in children. The mean ISS did not significantly differ between groups (4.0 versus 2.2, P = ns). Pediatric patients with facial burns treated with amniotic membranes had a higher incidence of dyspigmentation relative to adult patients (46.2% versus 9.1%, P ≤ 0.05). Remaining morbidities were not significantly different between adult and pediatric patients. All patients, irrespective of group, healed by the second post-operative week. Conclusion: Dehydrated amniotic membrane skin substitutes are a safe alternative in the treatment of facial burns across all ages.

Preoperative Anxiety and Postoperative Pain in Children with Burn Patients and Their Correlation Analysis

“…Regarding the reasons for the differences in preoperative anxiety scores at different ages, it can be seen from previous studies that with the increase of age, the psychological endurance of individuals is continuously improved, and the psychological emotions expressed in medical operations are also significantly different. This confirms the lower anxiety scores of older children in the present study (24,25).…”

Human Amniotic Membrane Usage from Bench to Bedside in Congenital Defects and Wounds in Paediatric Surgery: A Systematic Review

“…A study showed paediatric facial burns treated with hAM had a higher incidence of dyspigmentation relative to adult patients (46.2% versus 9.1%, P ≤ 0.05) 25 . 19.…”

“…f. The duration of hAM application in wounds: AM dressings can be changed till the red granulation tissue is replaced by a pale epithelial layer. g. Type of wounds/ defects: Most of the studies were on paediatric second and third-degree paediatric thermal burn 11,26,25,38 . Six studies on congenital birth defects (meningomyelocele) were identified in which, one study showed antenatal inutero repair and four were of postnatal repair 14,39,13 .…”

Biological importance of human amniotic membrane in tissue engineering and regenerative medicine

“…To date, the hAM has been broadly applied in clinical procedures, including gynecology [ 136 ], ophthalmology [ 137 ], neurosurgery [ 138 ], plastic surgery [ 139 ], gastrointestinal surgery [ 140 ], and orthopedics [ 141 ], as well as wound dressing for burns, or the acute and chronic wounds [ 121 , 142 ]. The clinical applications of hAM also have been reviewed in many publications [ [143] , [144] , [145] , [146] ]. These articles have investigated unmodified hAM applications.…”