Amniotic membrane in surgical wound management in epidermolysis bullosa: a case series
Pavel Rotschein1, Andrea Pokorná2, Martin Fiala1
1Department of Paediatric Surgery, Orthopaedics and Traumatology, University Hospital Brno, Černopolní 9 Brno, 61300, Czech Republic; Faculty of Medicine, Masaryk University, Kamenice 5, 62500, Czech Republic.
Aim Of The Study:
Postoperative wound care after reconstructive surgery in epidermolysis bullosa (EB) remains challenging because of extreme skin fragility, delayed epithelialization, and severe pain during dressing changes. Amniotic membrane has anti-inflammatory and regenerative effects that may support wound healing and provide mechanical protection. This study aimed to evaluate the clinical impact of amniotic membrane applied immediately after reconstructive surgery in patients with EB, focusing on wound healing, pain reduction, wound stability, and postoperative management.
Materials And Methods:
This case series included four patients with EB who underwent surgical release of pseudosyndactyly and correction of flexion contractures between 2025 and 2026 at a specialized national EB center. Surgical defects were covered with either lyophilized amniotic membrane (Amnioderm®) or cryopreserved amniotic membrane. Postoperative evaluation included epithelialization, wound stability, bleeding, exudation, and pain during dressing changes, assessed using the FLACC scale where applicable.
Results:
All patients demonstrated favorable postoperative wound healing, with complete epithelialization achieved within 14 days to 3.5 weeks after surgery. Dressing changes were tolerated at the bedside without analgosedation or general anesthesia. In two hand-surgery cases, FLACC scores on amniotic membrane-treated wounds were low (2 and 4), compared with 9 on the conventionally treated side. Sustained correction without recurrence was observed at 9-month follow-up in the revision case.
Conclusion:
Amniotic membrane appears to be a safe and effective adjunct in EB reconstructive surgery supporting wound healing and reducing pain during dressing changes. However, findings from this case series are preliminary and require confirmation in larger prospective studies.
