Effectiveness of Amnion on Chronic Wounds Vs Saline Dressing

Abstract

Introduction: Chronic wounds have deleterious effects on patient health and quality of life. Human placental membranes consist of amnion and chorion which are conjoined and avascular structures. These membranes have abundant growth factors and cytokines and extracellular matrix which can induce angiogenesis and dermal fibroblast proliferation and recruit mesenchymal stem cells involved in wound repair supplying an ideal environment for wound closure.

Aims & Objectives: To compare the effectiveness of human amnion vs. normal saline dressing in chronic wounds.

Place and duration of study: This study was conducted at Shaikh Zayed Medical Complex for a period of 6 months.

Material & Methods: This randomized control trial was carried out in the Department of Plastic Surgery at Shaikh Zayed Hospital, Lahore from 20-08-2019 to 20-02-2020. 60 patients of both genders,18 - 65 years of age having ulcers of more than six weeks duration and larger than 10 x 10 cm were inducted using non -probability consecutive sampling technique. They were divided into two groups of 30 patients each. Group A (Amnion) and Group B (Saline Dressing). Patients were assessed pre-treatment, wound dressings applied daily and followed up for 6 weeks for efficacy of dressing based on reduction in wound size and its relation to wound chronicity. Data was entered and analyzed using SPSS version 20.

Results: There were 27 (90%) male and only 3 (10%) females patients in group A and 21 (70%) male and 9 (30%) females patients in group B. Mean age of the patients was 45.60±12.51 years for group A and 44.20±11.65 years for group B. 27 (90%) patients demonstrated good efficacy of treatment at six weeks in group A as compared to 5 (17%) patients in group B which is statistically significant (P 0.041). Significant healing was noted in amnion treated chronic wounds of up to 21 weeks duration.

Conclusion: Our randomized control trial shows that amniotic membrane dressing are beneficial in the treatment of chronic wounds as compared to normal saline dressings.