Tobin Micaela J, Mustoe Audrey K, Nickman Sasha, Raquepo Tricia Mae, Yamin Mohammed, Posso Agustin N, Karinja Sarah J, Lee Bernard T, Cauley Ryan P
Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
J Clin Med. 2025 Jun 16;14(12):4272. doi: 10.3390/jcm14124272.
: The amniotic membrane, which is widely available and inexpensive, has received recent attention for its potential applications in wound healing. This is the first study to use a large database to examine the efficacy of amniotic membrane grafting compared to other skin substitutes. : The TriNetX electronic health database was queried in October 2024 for patients with burns or chronic skin ulcers. Patients were stratified by treatment with amniotic membrane grafts or another skin substitute. These patients were then 1:1 propensity score-matched based on age, demographics, and comorbidities. Group differences were assessed with risk ratios and -values. : A total of 557 patients remained in each group after propensity score matching. Patients who were treated with amniotic membrane grafts had significantly decreased hypertrophic scarring (1.7% vs. 6.2%, < 0.0001), local skin infections (17.4% vs. 29.9%, < 0.0001), and acute postoperative pain (3.7% vs. 7.8%, = 0.003). Additionally, subsequent split-thickness skin grafting was utilized significantly less after amniotic membrane grafts. When compared to skin substitutes for large wounds (>100 cm), the advantages of amniotic membrane were even more pronounced. : This multi-institutional study supports amniotic membranes as a viable alternative to conventional bioengineered skin substitutes. Further research should evaluate amniotic membranes in wound beds of different sizes to better characterize their use in preparation for or as an alternative to skin grafting itself.
羊膜广泛可得且价格低廉，其在伤口愈合中的潜在应用最近受到了关注。这是第一项使用大型数据库来研究羊膜移植与其他皮肤替代物相比疗效的研究。2024年10月，在TriNetX电子健康数据库中查询烧伤或慢性皮肤溃疡患者。患者按接受羊膜移植或其他皮肤替代物治疗进行分层。然后根据年龄、人口统计学和合并症对这些患者进行1:1倾向评分匹配。用风险比和P值评估组间差异。倾向评分匹配后，每组各有557名患者。接受羊膜移植治疗的患者肥厚性瘢痕明显减少（1.7%对6.2%，P<0.0001），局部皮肤感染明显减少（17.4%对29.9%，P<0.0001），术后急性疼痛也明显减轻（3.7%对7.8%，P = 0.003）。此外，羊膜移植后再次进行断层皮片移植的情况明显减少。与用于大面积伤口（>100平方厘米）的皮肤替代物相比，羊膜的优势更为明显。这项多机构研究支持羊膜作为传统生物工程皮肤替代物的可行替代品。进一步的研究应评估不同大小伤口床中的羊膜，以更好地明确其在为皮肤移植做准备或替代皮肤移植本身方面的用途。
