Scald burns in children are a common presentation to the emergency department. Burn injury has devastating long-term physical, psychological, and financial consequences for the child and family. The ideal dressing would require a 1-time application in the emergency department and would relieve pain, be readily available, be inexpensive, expedite healing, and reduce scarring.
Human amniotic membrane (HAM) is a byproduct of pregnancy that is typically discarded after birth. It has been used as a biologic wound dressing for centuries, and in 1913, Sabella was the first to report its use in the management of burns. Human amniotic membrane contains fibronectin, proteoglycans, glycosaminoglycans, laminins, and type IV, V, and VII collagen, as well as fibroblasts and pluripotent stem cells, all of which are required for tissue growth and repair.
These biologic characteristics are thought to contribute to the clinical efficacy of HAM in terms of reduced pain and infection, faster healing, and decreased scarring.
Commercially available collagen, which resembles HAM, is made from reconstituted bovine collagen . This collagen is a thin, transparent, acellular sterile sheet that is devoid of growth factors and stem cells. Both materials have been used as the inner layer of burn dressings.
DCunha in her study evaluated the benefit of 1 application of collagen and HAM , with the ability to dry without other dressing materials. After this material is completely dry, they form a hard layer, in about 6-8 hours, and when it is established the child is pain free.
A total of 43 children (25 boys, 18 girls) were enrolled in the study. None of the children received first aid in the form of cold running water for 20 minutes immediately after the burn occurred.
Complete dressing take was achieved in 93 children (40%). In 37% of these children (16 of 43), initial low-grade fever was managed with simple antipyretic agents, and antibiotics were not required. Low-grade fever may be attributed to the inflammatory response to the burn injury.
The average time to wound healing for both groups of patients in the current study was 10 days.
In the experience of the authors of the current study, the 2 dressing materials were comparable in terms of ease of application, need for reapplication, time to healing, and scarring. Human amniotic membrane is less expensive than collagen, so it is an excellent choice for use in economically disadvantaged areas in which collagen may not be available.
Aureen Ruby DCunha, MBBS, MS, Mch; Susan Jehangir, MBBS, MS, Mch; Grace Rebekah, BSc, MSc, PhD; Reju J. Thomas, MBBS, MS, DNB, DNB, Mch, (May 2022). Human amniotic membrane vs collagen in the treatment of superficial second-degree burns in children. National Library Of Medicine. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/35839158/
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