Monitoring, banking, and clinical use of amnion as a burn wound dressing

The preparation of human amniotic membrane obtained from cesarean delivery placentas for use in the treatment of acutely burned pediatric patients is presented. The technique of membrane harvesting and cleansing, bacteriological monitoring during various phases of preparation, and a method of ultracold long-term banking are described. A total of 187 membranes were stripped under aseptic conditions, cultured, treated in 0.025% sodium hypochlorite (NaOCl) for one minute and recultured. Fourteen organisms were recovered prior to NaOC1 treatment, and only 8 organisms after treatment. Amnions that grew any organism after hypochlorite treatment (23%) were deemed unsuitable for clinical use. Clinical experience with amniotic membranes in 36 acutely burned patients suggests that amnion is a cost-effective biological dressing, acceptable as an immediate dressing on superficial second-degree burns. It is also acceptable as an adjunct to meshed autograft over fascia, and as a temporary covering on recently excised wounds prior to autografting.