Biological versus non-biological dressings in the management of split-thickness skin-graft donor sites: a systematic review and meta-analysis

Amniotic Membrane Transplantation: Clinical Applications in Enhancing Wound Healing and Tissue Regeneration

Chronic wounds and non-healing tissue defects pose significant clinical challenges, necessitating innovative therapeutic approaches. A comprehensive literature review of amniotic membrane transplantation for wound healing and tissue repair evaluates the efficacy and safety of amniotic membrane transplantation in enhancing wound healing and tissue repair. Amniotic membranes promote wound closure and reduce inflammation and scarring via abundant growth factors, cytokines, and extracellular matrix components, which foster conducive environments for tissue regeneration. Amniotic membrane transplantation is effective in various medical disciplines, including ophthalmology, dermatology, and orthopedics. Low immunogenicity and anti-microbial properties ensure their safe application. Amniotic membrane transplantation offers a promising therapeutic approach for wound healing and tissue repair, and further research is warranted to explore its regenerative potential fully.

Application of Fetal Membranes and Natural Materials for Wound and Tissue Repair

The human fetal membrane is a globally accepted biological biomaterial for wound and tissue repair and regeneration in numerous fields, including dermatology, ophthalmology, and more recently orthopedics, maxillofacial and oral surgery, and nerve regeneration. Both cells and matrix components of amnion and chorion are beneficial, releasing a diverse range of growth factors, cytokines, peptides, and soluble extracellular matrix components. Beside fetal membranes, numerous natural materials have also been reported to promote wound healing. The biological properties of these materials may potentiate the pro-healing action of fetal membranes. Comparison of such materials with fetal membranes has been scant, and their combined use with fetal membranes has been underexplored. This review presents an up-to-date overview of (i) clinical applications of human fetal membranes in wound healing and tissue regeneration; (ii) studies comparing human fetal membranes with natural materials for promoting wound healing; and (iii) the literature on the combined use of fetal membranes and natural pro-healing materials.

A Randomized Controlled Trial of Three Advanced Wound Dressings in Split-Thickness Skin Grafting Donor Sites-A Personalized Approach?

Background: Split-thickness skin grafting (STSG) is a frequently used reconstructive technique, and its donor site represents a standardized clinical model to evaluate wound dressings. We compared hydroactive nanocellulose-based, silver-impregnated and ibuprofen-containing foam wound dressings. Methods: A total of 46 patients scheduled for elective surgery were evaluated on the STSG donor site for wound healing (time-to-healing, Hollander Wound Evaluation Scale), pain level (Visual Analogue Scale), and handling (ease of use), as well as scar quality (Patient Scar Assessment Scale, Vancouver Scar Scale) after 3, 6 and 12 months. Results: Almost all dressings compared equally well. We observed statistically relevant differences for pain level favoring the ibuprofen-containing dressing (p = 0.002, ΔAIC = 8.1), and user friendliness in favor of nanocellulose (dressing removal: p = 0.037, ΔAIC = 2.59; application on patient: p = 0.042, ΔAIC = 2.33; wound adhesion: p = 0.017, ΔAIC = 4.16; sensation on skin: p = 0.027, ΔAIC = 3.21). We did not observe any differences for wound healing across all groups. Treatment with hydroactive nanocellulose and the ibuprofen-containing foam revealed statistically relevant better scar appearances as compared to the silver wound dressing (p < 0.001, ΔAIC = 14.77). Conclusion: All wound dressings performed equally well, with the detected statistical differences hinting future directions of clinical relevance. These include the reserved use of silver containing dressings for contaminated or close to contaminated wounds, and the facilitated clinical application of the nanocellulose dressing, which was the only suitable candidate in this series to be impregnated with a range of additional therapeutic agents (e.g., disinfectants and pain-modulating drugs). Personalized donor site management with the tested dressings can meet individual clinical requirements after STSG and improve management strategies and ultimately patient outcomes.

Clinical Effect of Emergency Dermabrasion Combined with Biological Dressing A on Wound Microcirculation and Preventing Sepsis in Deep Degree-II Burns

Objective

The aim of this study is to explore the clinical effect of emergency dermabrasion combined with biological dressing A on wound microcirculation and preventing sepsis in deep degree-II burns.

Methods

A total of 90 patients with deep degree-II burns admitted to the hospital were retrospectively enrolled between January 2020 and January 2022. According to different treatment methods, they were divided into the control group (42 cases, biological dressing A) and the observation group (48 cases, emergency dermabrasion combined with biological dressing A). The clinical curative effect in both groups was observed. The wound repair rate and wound healing quality, and changes in levels of wound microcirculation-related indexes (serum epidermal growth factor (EGF), wound blood flow, and partial pressure of transcutaneous oxygen) and inflammatory cytokines (C-reactive protein (CPR), interleukin-6 (IL-6), erythrocyte sedimentation rate (ESR), and procalcitonin (PCT)) before treatment, at 3d and 7d after treatment were compared between the two groups. The incidence of wound infection and sepsis in both groups was recorded.

Results

The wound healing time in the observation group was significantly shorter than that in the control group, and wound healing quality in the observation group was better than that in the control group (P < 0.05). At 3 d and 7d after treatment, the levels of serum EGF, wound blood flow and partial pressure of transcutaneous oxygen in both groups were all increased (P < 0.05), which were higher in the observation group than those in the control group (P < 0.05). The levels of CRP, IL-6, ESR, and PCT in both groups were all decreased (P < 0.05), which were lower in the observation group than those in the control group (P < 0.05). There was no significant difference in incidence of sepsis between observation group and control group (4.17% (2/48) vs. 7.14% (3/42)) (Fisher = 0.539).

Conclusion

Emergency dermabrasion combined with biological dressing A can effectively improve wound microcirculation in patients with deep degree-II burns, promote wound healing, shorten wound healing time, improve wound healing quality, effectively control inflammatory response, and prevent sepsis.