A Novel Use of Amniotic Bilayer Dressing Co-cultured with Keratinocytes and Stem Cell as Skin Substitute in Adult Burn Patients

Nandita Putri^1,6, Aditya Wardhana^1,6, Normalina Sandora², Rahyussalim Rahyussalim^3,6, Alida Harahap^4,6, Nurjati Siregar^5,6, Hardisiswo Soedjana⁷,
¹1Department of Surgery, Plastic Reconstructive and Aesthetic Surgery Division, Universitas Indonesia, Jakarta, DKI jakarta, Indonesia
²ndonesia Medical Education and Research Institute (IMERI), Jakarta, Indonesia, Universitas Indonesia, jakarta, DKI jakarta, Indonesia
³Department of Orthopedics and Traumatology, Universitas Indonesia, jakarta, DKI jakarta, Indonesia
⁴Department of Clinical Pathology, Universitas Indonesia, jakarta, DKI jakarta, Indonesia
⁵Department of Pathological Anatomy, Universitas Indonesia, jakarta, DKI jakarta, Indonesia
⁶Dr. Cipto Mangunkusumo National Hospital, Jakarta, Indonesia, jakarta, DKI jakarta, Indonesia
⁷Department of Surgery, Plastic Reconstructive and Aesthetic Surgery Division, Universitas Padjajaran, Bandung, West JAva, Indonesia

Abstract

Background:
Survival outcome of burn patients is increasingly higher with early excision and grafting. The problem after excisional debridement is the need for a skin graft or a temporary dressing. By using amniotic membrane which is a biological waste we can limit the use of auto skin grafts.
Methods:
A preliminary prospective study was conducted on adult patients with no other comorbidities admitted to dr. Cipto Mangunkusumo Hospital Jakarta Burn Unit between 2021–2022. Patients were divided into three groups, treated with early excision and skin grafting, the amnion bilayer dressing or amniotic bilayer dressings co-cultured with keratinocytes and stem cells. The patients were then followed up for two weeks and the resulting epithelization in each group were analyzed including a skin biopsy for confirmation of the epidermal layer thickness.
Results:
A total of six patients, two in each group, were included in the study. The amniotic bilayer dressings co-cultured with keratinocytes and stem cell group has a rapid rate of epithelization (10% / day) compared to the early excision and skin grafting and amnion bilayer group (7,14% / day). It also has the thickest epidermal layer (95.7μm -range: 67.4-124.02μm) and the highest histological sore (7.00) at two weeks follow up.
Conclusion:
This preliminary study concluded that amniotic bilayer dressings co-cultured with keratinocytes and stem cells had an overall better outcome regarding the epithelization rate suggesting that further study is necessary to evaluate amniotic bilayer dressings co-cultured with keratinocytes and stem cell use in burn patients.

Biography

dr Nandita Melati Putri is a plastic surgeon specializing in burn and complex wound care in Universitas Indonesia. She is working at the number one national referral hospital in Indonesia, dr Cipto Mangunkusumo Hospital. She is also currently a medical staff in Cipto Mangunkusumo hospital burn unit.