title: Evaluation of human amniotic membrane as a wound dressing for split-thickness skin-graft donor sites.
abstract: Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Denys J
authors.initials: DJ
authors.lastname: Loeffelbein
authors.affiliation: Department of Oral and Maxillofacial Surgery, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Nils H
authors.initials: NH
authors.lastname: Rohleder
authors.affiliation: Clinic for Swine, Faculty of Veterinary Medicine, Ludwig-Maximilians-University of Munich, Sonnenstraße 16/A106, 85764 Oberschleissheim, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Eddicks
authors.affiliation: Department of Oral and Maxillofacial Surgery, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Claudia M
authors.initials: CM
authors.lastname: Baumann
authors.affiliation: Department of Oral and Maxillofacial Surgery, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Mechthild
authors.initials: M
authors.lastname: Stoeckelhuber
authors.affiliation: Department of Oral and Maxillofacial Surgery, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Klaus-D
authors.initials: KD
authors.lastname: Wolff
authors.affiliation: Department of Pathology, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Enken
authors.initials: E
authors.lastname: Drecoll
authors.affiliation: Department of Plastic, Reconstructive and Aesthetic Surgery, European Medical School at the Carl von Ossietzky University of Oldenburg, Evangelisches Krankenhaus, Steinweg 13-15, 26122 Oldenburg, Germany.
authors.forename: Lars
authors.initials: L
authors.lastname: Steinstraesser
authors.affiliation: Red Cross Blood Transfusion Service of Upper Austria/Austrian Cluster for Tissue Regeneration, Krankenhausstrasse 7, 4017 Linz, Austria.
authors.forename: Simone
authors.initials: S
authors.lastname: Hennerbichler
authors.affiliation: Department of Oral and Maxillofacial Surgery, Munich University of Technology, Ismaninger Straße 22, 81675 Munich, Germany.
authors.forename: Marco R
authors.initials: MR
authors.lastname: Kesting
mesh_terms: D000650:Amnion / Q000637:transplantation*; D000818:Animals; D001458:Bandages; D001485:Basement Membrane / Q000378:metabolism; D049109:Cell Proliferation; D004848:Epithelium / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000378:metabolism; D010146:Pain / Q000473:pathology; D011537:Pruritus / Q000473:pathology; D016038:Skin Transplantation; D034421:Sus scrofa; D014945:Wound Healing; D014841:von Willebrand Factor / Q000378:metabolism
chemical_list: D019394:Ki-67 Antigen; D014841:von Willebrand Factor