Amnion in the treatment of pediatric partial-thickness facial burns.
BACKGROUND
Wound coverage for second-degree burns remains a clinical challenge. Human amniotic membranes have been used for many years in the treatment of burns; however, no large prospective clinical trials have been published. In this article, we present a novel and standardized procurement and processing method for amnion and investigate, whether the use of this biological dressing is safe and may represent a new therapeutic option for children with partial-thickness facial burns compared to standard topical treatment.


METHODS
Patients with partial-thickness burns of the face, neck and head admitted between 2003 and 2005 were included in this study. They were divided into two groups to receive either amnion (n=53) or topical antimicrobials (n=49). Demographics (age, gender, ethnicity, TBSA, burn areas), length of hospital stay (LOS), rate of infections (RI), time to total healing, and frequency of dressing changes were compared between the two groups. The long-term outcome was assessed in nine patients in the amnion group and eight patients in the topical group, who returned for up to 12-month follow-up visits.


RESULTS
Patients in the amnion group had significantly less dressing changes then in the control group (p<0.05). Time to healing, length of stay and the development of hypertrophic scarring was not different between the groups. Use of amnion was not associated with an increased risk of local infection.


CONCLUSIONS
This study indicates that amnion is safe and has advantages as wound coverage for second-degree facial burns compared to the standard topical ointments. Further studies with the use of amniotic membranes on the trunk and the extremities, as well as for coverage of grafted third-degree burns, have yet to be performed.
Branski
Ludwik K
LK
Shriners Hospital for Children and University of Texas Medical Branch, 815 Market Street, Galveston, TX 77550, USA.
Herndon
David N
DN
Celis
Mario M
MM
Norbury
William B
WB
Masters
Oscar E
OE
Jeschke
Marc G
MG
D000293:Adolescent; D000650:Amnion / Q000637:transplantation*; D001684:Biological Dressings; D002056:Burns / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D002921:Cicatrix / Q000628:therapy; D005151:Facial Injuries / Q000628:therapy*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D013530:Surgical Wound Infection / Q000209:etiology; D016896:Treatment Outcome