Tissue Bank of Lille, Biology Pathology Center, CHU of Lille, Lille, France.
Department of Plastic Surgery, CHU of Lille, Lille, France.
Int Wound J. 2019 Dec;16(6):1354-1364. doi: 10.1111/iwj.13198. Epub 2019 Aug 19.
The use of split-thickness skin autografts (STSA) with dermal substitutes is the gold standard treatment for third-degree burn patients. In this article, we tested whether cryopreserved amniotic membranes could be beneficial to the current treatments for full-thickness burns. Swines were subjected to standardised full-thickness burn injuries, and then were randomly assigned to treatments: (a) STSA alone; (b) STSA associated with the dermal substitute, Matriderm; (c) STSA plus human amniotic membrane (HAM); and (d) STSA associated with Matriderm plus HAM. Clinical and histological assessments were performed over time. We also reported the clinical use of HAM in one patient. The addition of HAM to classic treatments reduced scar contraction. In the presence of HAM, skin wound healing displayed high elasticity and histological examination showed a dense network of long elastic fibres. The presence of HAM increased dermal neovascularization, but no effect was observed on the recruitment of inflammatory cells to the wound. Moreover, the use of HAM with classical treatments in one human patient revealed a clear benefit in terms of elasticity. These results give initial evidence to consider the clinical application of HAM to avoid post-burn contractures and therefore facilitate functional recovery after deep burn injury.
使用断层皮片自体移植物（STSA）与真皮替代物是治疗三度烧伤患者的金标准。在本文中，我们测试了冷冻保存的羊膜是否可以有益于目前的全层烧伤治疗。猪被施以标准化的全层烧伤损伤，然后随机分配到以下治疗组：（a）仅 STSA；（b）STSA 联合真皮替代物 Matriderm；（c）STSA 加人羊膜（HAM）；以及（d）STSA 联合 Matriderm 加 HAM。随着时间的推移进行了临床和组织学评估。我们还报告了 HAM 在一名患者中的临床应用。将 HAM 添加到经典治疗中可减少疤痕收缩。在 HAM 的存在下，皮肤伤口愈合显示出高弹性，组织学检查显示出密集的长弹性纤维网络。HAM 的存在增加了真皮新生血管形成，但对伤口中炎症细胞的募集没有影响。此外，在一名人类患者中使用 HAM 与经典治疗相结合，在弹性方面显示出明显的益处。这些结果初步证明了考虑将 HAM 应用于临床以避免烧伤后挛缩，从而促进深度烧伤后功能恢复的合理性。
