Background: Since the development of the meshed skin
grafts and the availability of different meshing expansion
sizes, the sizes of the meshed skin grafts interstices like all
open wounds became a problem because they increase the
metabolic needs and put the patients at the risk of infection.
The amniotic membrane satisfies most of the criteria for an
ideal biological wound dressing to solve such a problem.
Aim of Study: To determine the rate of healing of the
interstices of meshed skin autograft of 1:3 meshing size
applied to post burn raw areas when covered by fresh amniotic
membranes.
Patients and Methods: This study was conducted on 30
patients who had post burn raw areas with TBSA less than
30% divided into 2 groups Group (1): Used meshed STSG
(1:3) without amniotic membrane coverage Group (2): Used
meshed STSG 1:3 then covered with fresh amniotic membrane.
Biopsies were taken and examined. Patient and Observer Scar
Assessment Scale (POSAS) was used to evaluate the aesthetic
out come.
Results: Amniotic Membrane (AM) did not improve skin
graft take but it improved the macroscopic healing of the
interstices which showed significant p-value 0.005* and
registered valuable decrease in all items of Patient and Observer
Scar Assessment Scale (POSAS) that showed significant pvalues.
Also, AM accelerated the healing process histologically:
The chronic inflammatory cells started to appear early (pvalue:
0.003*). In the 10th day both the maturation of the
epithelium and the transformation of newly formed capillaries
into mature ones showed p-values (0.006*).
Conclusion: Amniotic membrane enhanced maturation
of epithelium, increased the transformation of the newly
formed capillaries into mature ones, accelerated the initiation
of the proliferative phase of wound healing, promoted the reepithelialization
of the interstices of the meshed graft and
led to a better cosmetic outcome.