Amniotic membrane is composed of amniotic epithelium, basement-membrane and stroma. Amniotic membrane is an easily obtained biomaterial and easily to be also processed, preserved and transported. However, its applicability will not be destroyed after it has been preserved for a long time(about one year). Thus it has been utilized widely in laboratory and clinical surgery. Generally, homologous amniotic membrane does not induce rejection after allotransplantation, and it is a bio-absorbable and degradable material. The purpose of this paper is to review the characteristics of amniotic membrane that makes it potentially useful in promoting tissue repair.
Amnion ; transplantation ; Biological Dressings ; Humans ; Tissue Engineering

PURPOSE: When choosing dressing method to treat skin defect by second degree or higher burn, we have to consider method of rapid epithelization and minimization of pain during the treatment. In this study, we used biologic dressing with cultured allogenic keratinocytes for skin defect due to burn. We followed up the degree of epithelization, the degree of pain, and patient satisfaction. METHODS: From June 2003 to June 2006, among the patients with skin defect due to burn, 31 cases with second degree burn(moderate to severe) were selected and biological dressing with cultured allogenic keratinocytes were done. 21 cases did not use cultured allogenic keratinocytes. Most of the patients had second degree burn. We applied cultured allogenic keratinocyte by Kaloderm. For wounds that were not deep enough to effect the dermis, escharectomy was done before applying Kaloderm. After the operation, moist wound site was maintained by dressing with saline gauze for 5-7 days. We compared the condition of the wound site before and after applying Keloderm by grading epithelization by standardized percentage scoring scale(1-5), and degree of pain and patient satisfaction by visual analogue scale(0-10). RESULTS: When cultured allogenic keratinocytes were applied for the same period of time, the mean score of epithelization were 3.29+/-0.529(mean+/-S.D.). Without the application, the mean score of epithelization were 2.86+/-0.655(mean+/-S.D.). The degree of pain was 7.71+/-1.419(mean+/-S.D.) and 2.35+/-0.950(mean+/-S.D.) before and after the application, respectively. The patients' satisfaction score was 6.45+/-0.850(mean+/-S.D.) and 8.45+/-0.961(mean+/-S.D.) before and after the application, respectively. CONCLUSION: Applying biological dressing with cultured allogenic keratinocyte to skin defect due to second degree burn showed satisfactory results in the degree of the epithelization, degree of pain and patients' satisfaction.
Bandages ; Biological Dressings ; Burns ; Dermis ; Humans ; Keratinocytes ; Patient Satisfaction ; Skin

BACKGROUND: To minimize the inflammatory reaction and improve healing, a new modified dermal substitute composed of an atelocollagen, chondroitin-6-sulfate, and amniotic membrane (AM) was applied to full-thickness skin defects in a pig. Atelocollagen was extracted from bovine skin, and two modified dermal substitutes were generated according to the cross-linking type. METHODS: The AM-collagen dermal substitutes were characterized and compared with currently used dermal substitutes in a pig skin defect model. There were five experimental groups: dehydrothermal (DHT) cross-linking atelocollagen with the AM on the top (AM-DHT), DHT and chemical cross-linking atelocollagen with the AM on the top (AM-DHT/chemical), Terudermis, Integra, and AlloDerm. After 3x3 cm full-thickness skin defects on the back of a pig were created, each dermal substitutes dermal substitutes was randomly grafted on the defects. Two weeks after grafting, autologous partial-thickness skin was over-grafted on the neodermis. The take rate of the dermal substitutes, skin, and histological sections were all assessed at 1, 2, and 4 weeks postoperatively. RESULTS: More rapid healing and a higher take rate were evident in the AM-DHT and Terudermis groups. Histological examination revealed fewer inflammatory cells and more fibroblast hyperplasia in these two groups. Four weeks after surgery, the amount of newly formed collagen was significantly more appropriate in the AM-DHT group. CONCLUSIONS: These observations provide supporting evidence that a newly developed amniotic-collagen dermal substitute may inhibit inflammatory reactions and promote wound healing.
Amnion ; Biological Dressings ; Chondroitin Sulfates ; Collagen ; Dermis ; Fibroblasts ; Hyperplasia ; Skin ; Skin, Artificial ; Transplants ; Wound Healing

PURPOSE: In the past days, the majority of 2nd degree burns were treated conservatively, and deep 2nd degree burns were usually covered by skin grafts. However, conservative treatment spends a long time in complete healing and accompanies severe pain and discomfort. Additionally, covering the wound with skin graft causes recipient site scarring and donor site morbidity. Since keratinocyte graft was introduced, nowadays it is widely used in burn wound. These treatment methods are proved to be clinically successful by many clinical and experimental studies. However, there are several disadvantages such as inconvenient using methods and limited usage in several cases. For that reason, at 2004, alloplastic material was first introduced to come over these problems of keratinocyte graft. There had been no precious reports comparing theses two methods, so we planned to focus on differences of two methods in our institute. METHODS: From March 2013 to september 2014, among the 47 patients with burn wound (2nd degree - partial 3rd degree) underwent biologic dressing with cultured keratinocyte allograft (Kaloderm(R) (Tegoscience, Korea)) alloplastic material (Suprathel(R) (Polymedics Innovations GmbH, Germany). The outcomes were assessed using time for epithelization, TBSA (%), Vancouver Scar Scale and complication. RESULTS: All burn wounds were completely epithelized without any complication. The average time for epithelization was 13.4/13.4 days. CONCLUSION: The result of this study suggests that Kaloderm(R) and Suprathel(R) did not show significant difference. Therefore, Suprathel(R) may be considered as an alternative choice for treating 2nd and 3rd degree burns in some clinical settings.
Allografts* ; Biological Dressings ; Burns* ; Cicatrix ; Humans ; Keratinocytes* ; Skin ; Tissue Donors ; Transplants ; Wounds and Injuries

BACKGROUND: The main goal in the management of an open wound is to obtain a clean and closed wound in the shortest time. Open wounds, including chronic and acute ulcers, occur frequently, and are painful and difficult to heal. We evaluated the usefulness of human amniotic membrane for management of ulcers, due to its easy accessibility, negliable cost and healing properties. OBJECTIVE: The aim of this study was to confirm the findings on the use of human amnion in the treatment of post-phlebitic, post-burn chronic ulcers and postoperative wound defects. METHODS: We treated 12 patients with non-healing ulcers, and postoperative wound defects, using human amniotic membrane. RESULTS: Most patients experienced immediate and impressive relief of pain after application of the amniotic membrane. The ulcer beds treated with amnion were vascular and filled with granulation tissue. Human amniotic membranes kept the wounds bacteriologically clean, thus allowing spontaneous closure to occur and reduced the time required for healing and convalescence. CONCLUSIONS: Human amniotic membrane was successfully used as a biological dressing for treating ulcerations, including chronic ulcers and postoperative wound defects. It can serve as either a permanent therapy or as a temporary measure until the inflammation subsides.
Amnion* ; Biological Dressings ; Convalescence ; Granulation Tissue ; Humans ; Inflammation ; Ulcer* ; Wound Healing ; Wounds and Injuries

OBJECTIVETo describe the methods which were used to develop collagen-based materials for wound dressing.

METHODSFresh frozen bovine tendon was treated with 0.05 mol/L acetic acid at pH 3.2 for 48-72 hours, homogenized, filtered, mixed with 8% chondroitin sulphate, for creating a deaerated 1.5%-2.5% collagen solution. The solution was lyophilized in either a pre-frozen or non-pre-frozen mould. The collagen sponge was then cross-linked with 0.25% glutaraldehyde for 24 hours. Three other types of wound dressings were developed using a similar method: collagen membrane with a polyurethane membrane onlay, polyurethane-coated collagen membrane and collagen membrane on gauze.

RESULTSIt was demonstrated that the use of frozen bovine tendon was stable, and that the prepared collagen sponge contained pores of 50-400 microm in diameter.

CONCLUSIONSCollagen could be used as wound dressing.

Amino Acids ; analysis ; Animals ; Biological Dressings ; Cattle ; Collagen ; analysis ; chemistry ; isolation & purification ; Freeze Drying ; Polyurethanes

PURPOSE: With the advances of knowledge in wound healing process and technology in various fields, dressing material of the split thickness skin graft (STSG) donor site was improved. Recently, biologic dressing materials attracted attention and these are used for wound management. The aim of the study was to compare the efficacy of Xe-derma® (porcine acellular dermal matrix) with Kaloderm® (cultured epithelial autografts) for treatment of the donor site. METHODS: From July 2015 to January 2016, 20 patients who had undergone STSG were enrolled. The grafts harvested with a same manner and the donor sites were managed with Xe-derma® or Kaloderm®. We compared days for re-epithelization, number of dressings, ease of application, ease of wound monitoring, pain level and complications. RESULTS: All patients managed by these dressing materials were well healed without any complications. There is no statistically difference (P=0.830) between the days for re-epithelization of Xe-derma® (11.10±0.944) and Kaloderm® (11.00±1.054). Number of dressings of Xe-derma® (1.2±0.421) was lower than Kaloderm® (2.3±0.483). Ease of application of Kaloderm® (7.40±0.516) was easier than Xe-derma® (6.36±0.343). Ease of wound monitoring of Xe-derma® (7.77±0.856) was easier than Kaloderm® (6.25±0.720). Xe-derma® was more painless in 1 day and 3 days after operation than Kaloderm®. CONCLUSION: Advantageous properties of Xe-derma® are improving wound healing, reducing pain by contact to the wound immediately after application and easy of wound monitoring due to its transparency. Therefore, we expected Xe-derma® can be used for management of various wound.
Bandages ; Biological Dressings* ; Humans ; Skin* ; Tissue Donors* ; Transplants* ; Wound Healing ; Wounds and Injuries

BACKGROUND: Amniotic membrane contains basement membrane components and several growth factor proteins. Therefore, transplantation of amniotic membrane might help epithelialization. OBJECTIVE: The purpose of this study was to compare efficacies of amniotic membrane patches (amniotic group), polyurethane film (TegadermTM, 3M, USA: wet group), and nonadherent dressing (dry group) in wound healing. METHOD: Six rabbits were included in this study. We made wound defects on the back of each rabbit. Amniotic membrane patches (amniotic group) was applied to each wound defect in the first group, polyurethane film (TegadermTM, 3M, USA: wet group) to the second group, and nonadherent dressings (dry group) to the third group. We compared the time taken for each wound defect to heal, and the gross and histopathologic change of the wound defect from baseline, over time. RESULTS: The results were as follows: 1. In the early phase, the amniotic membrane patch (amniotic group) resulted in a faster healing time than either the polyurethane film (TegadermTM, 3M, USA: wet group) or the nonadherent dressing (dry group). 2. On day 10, all groups achieved histological epithelialization. 3. In the late phase, the amniotic membrane patch (amniotic group) might inhibit collagen fiber arrangement and development of skin appendages. CONCLUSION: The amniotic membrane patch is effective in the treatment of rabbit wound defects. It can serve as a biological dressing in the early phase of wound defects.
Amnion* ; Bandages ; Basement Membrane ; Biological Dressings ; Collagen ; Polyurethanes ; Rabbits ; Skin* ; Wound Healing* ; Wounds and Injuries*

PURPOSE: The biggest problem of wound healing is a possible occurrence of lesion. Especially, in the case of patients who have a skin injury around exposed body parts, if their treatment period drag on for long time, they can suffer from after-effects and the costs can be passed on to a society. Therefore, in this research, we investigated the need to develop the effective medicine and appliances for the patients by examining which therapy methods are being applying to the skin damage and what is the advantage and limit by evaluating the patient's satisfaction level. METHODS: We carried out an online and offline survey targeting medical teams in order to analyze device for wound care. A total of 125 medical teams applied to the research, and investigate the level of customer satisfaction. RESULTS: The moist dressings are the most used method for wound healing. When it comes to the level of customer satisfaction, biological dressing product also has a high satisfaction level. However its high cost tends to limit the use. CONCLUSION: This research reached a conclusion that it is need to develop a low cost and high efficiency wound care product considering the fact that its high cost and low efficiency induced economic problems. Generally, it is needed to develop a product for skin regeneration based on biological technologies, not a product just for damage cure.
Bandages ; Biological Dressings ; Human Body ; Humans ; Methods ; Regeneration ; Skin ; Wound Healing ; Wounds and Injuries*

OBJECTIVETo study the effect of biological protective dressing made from porcine peritoneum in covering wounds with microskin grafts.

METHODSTwenty New Zealand rabbits were divided into ten couples according to the random number table. Rabbits in each couple underwent surgery at the same time. A piece of full-thickness skin of 5 cm in diameter was removed symmetrically from the left and right sides of the back of each rabbit, thus forming two wounds with full-thickness skin defect. One fifth of one piece of skin of one rabbit was cut into tiny pieces of 0.2-0.5 mm in size (microskin). Then the microskin pieces were spread on the two wounds of the donor rabbit with the microskin/wound area ratio 1:10. The two wounds of each rabbit covered with microskin were divided into two groups according to the random number table. One wound was covered with biological protective dressing prepared with porcine peritoneum as experiment group, and the other was covered with the rest allograft in full size obtained from the other rabbit of each couple as control group. The general condition of wound was observed at post operation week (POW) 1-4. Wound healing rate was calculated at POW 3 and 4. Wound healing time was recorded. Specimens were harvested from wounds for histological observation at POW 1-4. Data were processed with paired t test.

RESULTS(1) At POW 1, the biological protective dressings were found to attach firmly to the wounds in experiment group without obvious inflammatory response; the allografts survived well on the wounds in control group. At POW 2, the coverings attached well to the wounds of both groups, but became drier and darker as compared with those at POW 1. At POW 3, some wounds of the two groups healed when the coverings desiccated and separated. At POW 4, all the wounds of both groups healed without obvious difference in appearance. (2) The wound healing rates of the experiment and control groups were respectively (92.8 ± 6.2)% and (91.3 ± 7.3)% (t = 0.54, P > 0.05) at POW 3 and (98.1 ± 2.3)% and (97.0 ± 4.6)% (t = 0.38, P > 0.05) at POW 4. (3) The wound healing time was (25.0 ± 3.9) d in experiment group and (24.8 ± 2.3) d in control group. The difference between them was not statistically significant (t = 0.82, P > 0.05). (4) Histological observation showed that wounds of the two groups were all infiltrated by inflammatory cells, and new blood vessels were observed at POW 1 and 2. The survived microskin proliferated under the coverings. At POW 3 and 4, the coverings on the wounds of two groups were gradually degenerated and became necrotic and separated from the wound beds, while the wounds underneath were re-epithelialized.

CONCLUSIONSThe effect of biological protective dressing in covering wounds grafted with microskin is as good as that of the allograft, as they both help the auto-microskin proliferate and repair the wound. It could be considered to be new biological material for clinical application.

Animals ; Biocompatible Materials ; Biological Dressings ; Male ; Peritoneum ; Rabbits ; Skin Transplantation ; methods ; Swine ; Wound Healing