Collagen sheet application is the more economical and well-studied option for primary burn wounds, and is the norm in most institutes in India.
Not much literature available for the use of amniotic membrane in burns other than for the donor site of a graft (in which results are good) rather than for the wound itself. Unsure if the local and systemic changes that occur in response to burns would be conducive to the uptake of an amniotic membrane graft, and the inflammatory phase can be considerably catabolic on the graft. Application of collagen in the acute phase followed by amniotic membrane once the collagen has peeled off would give good results if economically feasible.
Any specifications regarding grade, site, nature of burns, Sir?
Amniotic membrane has been reported to be a successful skin substitute in acute burns.. we recently published a case that references below.
A. El Youssoufi,1, E.J.L. Malonga-Loukoula,1 K.S. Amouzou,2 andM. Diouri1 Auto-transplantation of amnion-chorion membrane in a burned pregnant patient at term Ann Burns Fire Disasters. 2018 Dec 31; 31(4): 292–297.
Published online 2018 Dec 31.
its very useful especially in ocular injuries Article Amniotic membrane transplantation for acute chemical or thermal burns
Unfortunately there are difficulties to determine the degree and depth of burn in acute stage so, 1st , 2nd nf 3rd degrees burn are having different management so we can not use amniotic membrane in acute staged of burn
It works for every burn depth as temporal patch... bypassing the potential infectious risks, the amniotic membrane has to be cleansed and prepared to be used, three decades ago they used them in my hospital for massive burnt patients who could not be skin-grafted in one single session... they were free (we asked the obstetrics department to save them for us and PRS residents prepared them) you WILL have to skin-graft the patient anyway for deeper wounds
You mean that the using of amniotic membrane are as biological covering ok, but I believe that in 2nd and 3rd degrees diagnosed burn
the only permanent coverage for burn resurfacing is autologous skin. All other options are only temporary. In case of use of artificial use as Integra, it represents a definitive replacement for the dermis but the epidermis is still to be added in the form of autologous split thickness graft.
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