Effect of amniotic membrane on graft take in extremity burns

Several studies have shown that the application of amniotic membrane as a biological dressing in the management of burns is accompanied by rapid re-epithelialisation and healing as it diminishes the oozing of plasma, bacterial count and fluid, protein and heat loss. This study evaluates the effect of amniotic membrane on graft take in split-thickness skin graft of extremity burns.

From October 2008 to January 2010, in a prospective clinical trial, 54 patients (108 limbs) with second and third degree burns, covering 4-15% of total body surface area (TBSA), were included in this study. All patients needed split-thickness skin grafts for burn-wound coverage. Selected patients had symmetric burns on two (upper or lower) extremities. Then in every patient, the extremities were randomly divided into two groups: in one limb, the skin graft was traditionally fixed with skin staples (control group) and in the other limb the skin graft was covered with an amniotic membrane (amnion group). Therefore, in every patient the graft was covered with an amniotic membrane in one extremity and fixed with skin staples in the other extremity. Finally, the duration and success rate of complete graft take was compared between the two groups.

The study group was composed of 108 limbs in 54 patients (27 males and 27 females) with a mean age of 23.54±4.9 years and burn 9.03±2.69% TBSA. The mechanism of burn was flame (63%), scald (18.5%) and flash (18.5%). The rate of complete graft take was 96.76% and 88.79% in the amnion group and in the control group, respectively. The mean duration of graft take was 6.98±1.35 days in the amnion group and 13.9±1.66 days in the control group. This difference was statistically significant (P<0.001).

Our results show that although the amniotic membrane has no negative impact on graft take, it significantly reduces the duration of complete graft take, which is very important for both the patient and the health-care system.