Healing Effects of Dried and Acellular Human Amniotic Membrane and Mepitelas for Coverage of Skin Graft Donor Areas; A Randomized Clinical Trial

Masoumeh Nouri, Marzieh Ebrahimi, Tooran Bagheri, Mohammad Javad Fatemi, Arash Najafbeygi, Shirin Araghi, Maryam Molaee

Abstract

Objective: To compare the healing effects of dried and acellular human amniotic membrane and Mepitel for coverage of split-thickness graft donor site (STGDS).  

Methods: Twenty patients who underwent STGDS regeneration surgery in identical anatomic regions were enrolled in this randomized controlled clinical trial conducted in Hazrate Fatemeh hospital (Iran). Patients were randomly assigned in 3 groups of wound dressing; group A by Mepitel, group B AmiCare (Dried amniotic membrane) and group C OcuReg-A (Acellular amniotic membrane). Re-epithelization rate (healing time), pain sensation, scar formation and infection rate were assessed till complete healing was achieved.

Results: Our results showed no significant difference between Amicare, OcuReg-A and Mepitel in the features analyzed by us including: Re-epithelization rate (healing time) P value; 0.573, Pain sensation P value: day 4 th: 0.131, day8 th: 0.93 and day 12 th: 0.365, Scar formation P value>0.05 and Infection rate.

Conclusion: Our findings confirmed the safety and efficacy of AmiCare (dried amniotic membrane) and OcuReg-A (Acellular amniotic membrane) in treatment of split-thickness donor site in comparison with Mepitel as a standard wound dressing.

Trial registration number: IRCT201511118177N12.

Keywords

Split-thickness donor site; Dried amniotic membrane; Acellular amniotic membrane; Mepitel; Re-epithelization

Full Text:

PDF XML HTML FIGS

References

Litwiniuk M, Grzela T. Amniotic membrane: new concepts for an old dressing. Wound Repair Regen. 2014;22(4):451-6.

Singh R, Purohit S, Chacharkar MP, Bhandari PS, Bath AS. Microbiological safety and clinical efficacy of radiation sterilized amniotic membranes for treatment of second-degree burns. Burns. 2007;33(4):505-10.

Gruss JS, Jirsch DW. Human amniotic membrane: a versatile wound dressing. Can Med Assoc J. 1978;118(10):1237-46..

Dornseifer U, Lonic D, Gerstung TI, Herter F, Fichter AM, Holm C, et al. The ideal split-thickness skin graft donor-site dressing: a clinical comparative trial of a modified polyurethane dressing and aquacel. Plast Reconstr Surg. 2011;128(4):918-24.

Huang G, Ji S, Luo P, Liu H, Zhu S, Wang G, et al. Accelerated expansion of epidermal keratinocyte and improved dermal reconstruction achieved by engineered amniotic membrane. Cell Transplant. 2013;22(10):1831-44.

Lo V, Pope E. Amniotic membrane use in dermatology. Int J Dermatol. 2009;48(9):935-40.

Singh R, Chacharkar MP. Dried gamma-irradiated amniotic membrane as dressing in burn wound care. J Tissue Viability. 2011;20(2):49-54.

Sun W, Li ZR, Yang YR, Shi ZC, Wang B, Liu B, et al. Experimental study on phase-contrast imaging with synchrotron hard X-ray for repairing osteonecrosis of the femoral head. Orthopedics. 2011;34(9):e530-4.

Hodde J. Naturally occurring scaffolds for soft tissue repair and regeneration. Tissue Eng. 2002;8(2):295-308.

Matsumura H, Meyer NA, Mann R, Heimbach DM. Melting graft-wound syndrome. J Burn Care Rehabil. 1998;19(4):292-5.

Drugs CAf, Health Ti. Dressings and Care of Skin Graft Sites: Review of Clinical Evidence and Guidelines: Canadian Agency for Drugs and Technologies in Health; 2013.

Mostaque AK, Rahman KB. Comparisons of the effects of biological membrane (amnion) and silver sulfadiazine in the management of burn wounds in children. J Burn Care Res. 2011;32(2):200-9.

Singh R, Chacharkar MP. Dried gamma-irradiated amniotic membrane as dressing in burn wound care. J Tissue Viability. 2011;20(2):49-54.

Bujang-Safawi E, Halim AS, Khoo TL, Dorai AA. Dried irradiated human amniotic membrane as a biological dressing for facial burns--a 7-year case series. Burns. 2010;36(6):876-82.

Singh R, Purohit S, Chacharkar MP, Bhandari PS, Bath AS. Microbiological safety and clinical efficacy of radiation sterilized amniotic membranes for treatment of second-degree burns. Burns. 2007;33(4):505-10.

Waikakul S, Chumniprasas K, Setasubun S, Vajaradul Y. Application of freeze-dried amniotic membrane: a control trial at the donor site of split-thickness skin grafting. Bull Hosp Jt Dis Orthop Inst. 1990;50(1):27-34.

Sun W, Li ZR, Yang YR, Shi ZC, Wang B, Liu B, et al. Experimental study on phase-contrast imaging with synchrotron hard X-ray for repairing osteonecrosis of the femoral head. Orthopedics. 2011;34(9):e530-4.

Massee M, Chinn K, Lei J, Lim JJ, Young CS, Koob TJ. Dehydrated human amnion/chorion membrane regulates stem cell activity in vitro. J Biomed Mater Res B Appl Biomater. 2016;104(7):1495-503.

Maan ZN, Rennert RC, Koob TJ, Januszyk M, Li WW, Gurtner GC. Cell recruitment by amnion chorion grafts promotes neovascularization. J Surg Res. 2015;193(2):953-62.

Park M, Kim S, Kim IS, Son D. Healing of a porcine burn wound dressed with human and bovine amniotic membranes. Wound Repair Regen. 2008;16(4):520-8.

Wilshaw SP, Kearney J, Fisher J, Ingham E. Biocompatibility and potential of acellular human amniotic membrane to support the attachment and proliferation of allogeneic cells. Tissue Eng Part A. 2008;14(4):463-72.

Wilshaw SP, Kearney JN, Fisher J, Ingham E. Production of an acellular amniotic membrane matrix for use in tissue engineering. Tissue Eng. 2006;12(8):2117-29.

White R, Morris C. Mepitel: a non-adherent wound dressing with Safetac technology. Br J Nurs. 2009;18(1):58-64.