Beruflich Dokumente
Kultur Dokumente
Biological Dressing
Use of
as a
T. Viswanatha
Amnion
The
credited
Visakhapatnam, India.
Reprint requests to Department of Pediatric Surgery, Andhra
College, Visakhapatnam 530 002, India (Dr Rao).
Medical
popular
and is
extensively
used
by
field.
We have attempted a simpler technique that eliminates
the need for a costly amnion bank and that enables storage
at room temperature. The twin problems of preservation
by a simple technique and provision of adequate supplies
when most needed will be solved by (1) preserving the
amnion in the dry state and (2) using the bovine amnion to
provide bulk supplies. This communication recounts our
experiences with these two products.
Table 1 gives the characteristics of the two types of
amnion. The large surface of the bovine amnion is worth
noting. Our figure for the human amnion is at variance
with that of Troensgaard-Hansen,5 who claims only 52 sq
cm (8 sq in) of amnion as being available from a single
placenta.
The normal
requirement
of
biological dressing
for 50%
Fig
no
cost.
Experimental
Animals
covers.
until the healing was complete. Cultures were taken from the
wound surfaces during these inspections. No other treatment was
given to the animals.
polythene
Clinical
Subjects
Human
Surface area,"
1,600
6,000-7,500
Shape
Spherical
Cylindrical
Thickness, /im
10
Histologie ap
Single layer
sq
cm
15
Single layer of
of
cuboidal
cuboldal
pearance
epithelium
Table
as
circumference
epithelium
length or height.
of Cases
2.Types
Amnion
Human
Fresh
Humans
Burns
Skin graft donor sites
Dry
Bovine,
Dry Only
Total
15
32
58
20
39
12
70
12
Ruptured meningoceles
Pressure
Total
Rabbits
Fig
sores
11
Age
11
0-1 yr
1-4 yr
5-8 yr
9-12 yr
Adult
Total
15
11
23
47
70
Degree
Mixed
Deep
Superficial
of Burns
23
10
10
16
10
20
30
40
50
>50
Total
Data for the
wound
50s
20
29
remaining eight
sepsis only,
Total
cases are
the amnion
was
missing.
changed after
24 to 48
hours.
RESULTS
Experimental Animals
The safety and effectiveness of the bovine amnion has
been established. All of the rabbits survived the procedure.
The wounds healed within three weeks. The membrane
adhered to the wound surface and remained adherent
throughout the period of healing, even though it was not
sutured and a dressing was not applied. A single applica
tion was enough.
Fig 4.Baby
man).
with
amnion
(hu
Subjects
A single application was adequate in superficial burns,
except in sodden areas like the perineum. The membrane
Clinical
Fig
outpatients.
COMMENT
Terminology
and
Types
of 'Amnion'
are
terms used
membrane.
Amnion seems to satisfy all the criteria of an ideal
biological dressing: an effective vapor barrier, adherence,
durability, bacteriostatic activity, protection from pain,
and elasticity.16
Vapor Barrier
Amnion is an excellent vapor barrier. It resembles in this
Physiological
and
Biological Properties
Bonding
Advantages
especially
in
tenance of
References
1. Davis JS: Skin transplantation, with a review of 550 cases at the John
Hopkins Hospital. Johns Hopkins Hosp Rep 1910;15:307.
2. Sabella N: Use of foetal membranes in skin grafting. Med Rec NY
1913;83:478.
1940;1:517-519.
1953;138:618-630.
7. Silvetti AN, Cotton C, Byrne RJ, et al: Preliminary studies of bovine
embryo skin grafts. Transplant Bull 1957;4:25.
8. Dino BR, Eufemio GG, DeVilla MS: Human amnion: The establishment
of an amnion bank and its practical applications in surgery. J Philip Med
Assoc 1966;42:357-366.
9. Song IC, Bromberg BE, Mohn MP, et al: Heterografts as biological
dressings for large wounds. Surgery 1966;59:576.
10. Colocho G, Graham WP III, Greene AE, et al: Human amniotic
abscess. The authors had difficulty using it over a fullthickness wound, and indeed this is the experience of others who
have tried either a biological dressing or a synthetic dressing such
as Hydron Wound Dressing (Abbott Laboratories, North Chicago,
111) over full-thickness injuries. Biological dressings are best used
for partial-thickness injuries or full-thickness injuries after the
eschar has been totally excised.
Despite objections to the specific points mentioned, the article
describes a way to dry amnion and preserve it for long periods of
time. If one is desirous of a biological dressing to serve only as a
cover and not function as a biological-physiological dressing, these
techniques may prove to have value.
Martin C. Robson, MD
on an
Chicago