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Published on: December 21, 2014
Dehydrated Human Amnion Chorion Membrane as Treatment for Pediatric Burns
Natasha Ahuja1, Richard Jin2, Colin Powers2
1Department of Surgery, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, New York, USA.
Insights
Dehydrated human amnion chorion membrane (dHACM) offers excellent healing for pediatric burns, comparable to skin grafts but with fewer scars and contractures. This regenerative treatment may be a superior alternative for managing pediatric burns.
Area of Science:
- Regenerative Medicine
- Pediatric Burn Care
- Wound Healing
Background:
- Pediatric burns cause significant injury, potentially leading to lifelong impairment.
- Split-thickness skin autografts are standard but cause morbidity.
- Alternative skin substitutes are being explored.
Purpose of the Study:
- To evaluate dehydrated human amnion chorion membrane (dHACM) as a treatment for pediatric burns.
- To compare dHACM outcomes with traditional split-thickness skin grafts.
Main Methods:
- A case series of 30 children with various burn types treated with dHACM.
- Analysis of healing rates, hypertrophic scarring, and contractures.
Main Results:
- dHACM demonstrated excellent healing rates, comparable to split-thickness skin grafts.
- Treatment with dHACM resulted in lower rates of hypertrophic scar and contracture.
- dHACM contains regenerative factors that reduce scarring risk.
Conclusions:
- dHACM is a safe, feasible, and potentially superior alternative to split-thickness skin grafting for pediatric burns.
- dHACM can decrease downstream costs associated with burn management.
- This approach challenges the current standard of care for pediatric burn treatment.
Abstract:
Objective: Pediatric burns are a major source of injury and in the absence of adequate care can lead to lifelong functional loss and disfigurement. While split thickness skin autografts are the current standard of care for deep partial and full-thickness burns, this approach is associated with considerable morbidity. For this reason, alternative skin substitutes such as allografts have gained interest. Approach: In the present study, we present a case series of 30 children with various types of burns treated with dehydrated human amnion chorion membrane (dHACM). Results: We show that treatment with dHACM is associated with an excellent rate of healing comparable to split thickness skin grafts with less rate of hypertrophic scar and contracture. Innovation: Treatment with dHACM is particularly attractive as it consists of many tissue regenerative factors, such as growth factors and immune modulators, thus it will reduce the risk of scaring. Conclusion: While dHACM is associated with an increased upfront cost, treating patients with small to moderate-sized burns with dHACM in their regional centers works to decrease downstream costs such as management of prolonged pain from donor-site morbidity, revisional surgeries from scar and contractures of split thickness grafts, and avoiding the cost of transfer to higher level centers of care. Our findings challenge the current standard of care, suggesting that dHACM provides an alternative to the current use of split thickness skin grafting and is a safe, feasible, and potentially superior substitute for the management of small to moderate total body surface area partial and full-thickness pediatric burns.
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