Presented by:

Vinny Varghese
Asst professor
BMCON
 Burn is still a devastating emergency with
many physical and psychological disabilities,
mortality and morbidity.
Bacterial invasion is the commonest
obstacle to the healing process.
Another less appreciated factors which
impairs healing is the passive evaporative
water and heat loss
 Human amniotic
membrane is comprised of
two distinct but conjoined
membranes – amnion and
chorion.
• The membranes consist of organized collagen-
rich extracellular matrix, cytokines, epidermal
growth factors, regulatory proteins and
signaling molecules.
• Embryologically, the membrane is derived
from fetal ectoderm and hence can be
considered as analogous to fetal skin allograft.
 PROPERTIES
 Promotion of epithelialization
 Anti inflammatory property
 Anti fibrosis property
 Anti microbial property
 Immunogenicity
 Mechanical property
When used as a biological dressing, AM
has been credited with the following
functions:
Protection from protein and fluid loss
Bacteriostatic function
Reduction of pain
Enhanced wound healing
Placenta from clean vaginal deliveries, emergency
or elective C-sections of seronegative mothers
(HIV, HBsAg, HCV, and other transplacental
transmissible diseases) are collected in a bowl

Placenta from mothers with the following

conditions are rejected- PROM, H/o veneral
diseases, meconium stained, h/o endometritis
or pelvic inflammatory diseases
 TRANSPORTATION

Placenta is
then transferred
to burns ICU
preparation
room
Placenta then thoroughly cleaned
with NS to wash out all blood

Amnion is separated under sterile

precautions and then soaked in
heparin solution and followed by
antibiotic solution over-night
Washing under running
water • Washing with NS
• Separation of amnion • Amnion
• Soaked in heparin • Soaked in gentamycin
solution
• Amnion is preserved in
85% glycerol
• Temperature is
maintained at 40C
 Using sterile technique, the Amnion removed
from the container, washed with NS before
application and applied over area of burns
previously cleaned and debrided.
 All air and fluid blebs are smoothened out to
ensure total contact and excess membrane is
trimmed
 Expiry date- upto 2.5 years after preparation
when stored in 85% glycerol
• Readily available
• sterilization, storage and application are
simple
• Prevents fluid, protein and energy loss
• Combacts infection
• Promotes healing
• Relieves pain
 A Study was done as a clinical trial over 32
admitted patients in burn department of Beasat
hospital to identify the Healing Effect of
Amniotic Membrane in Burn Patients
Skin graft was taken from 2 sites in every
patient. One site dressed with amnion and
another with routine dressing. Then two sites
were compared about severity of pain, move
score, infection and time of dressing sloughing.
 Results: The average pain score in the
intervention areas was less than the control
areas. Also showed that the intervention cases
which were dressed by the amniotic membrane
had a better movement status in comparison to
the routine dressing
 A single-blind randomized controlled
clinical trial from March to October 2006 was
conducted among 211 patients with less than
20% burn and were enrolled into two groups.
The first group contained 104 patients for whom
amnion dressing was used. The second group
composed of 107 patients treated with routine
silver sulfadiazine dressing.
 Results: Amniotic membrane usage
was accompanied by acceleration in wound
healing, less need for skin graft, and less pain.