Hyperdry human amniotic membrane application as a wound dressing for a full-thickness skin excision after a third-degree burn injury

Jiro Oba; Motonori Okabe; Toshiko Yoshida; Chika Soko; Moustafa Fathy; Koji Amano; Daisuke Kobashi; Masahiro Wakasugi; Hiroshi Okudera

doi:10.1093/burnst/tkaa014

Hyperdry human amniotic membrane application as a wound dressing for a full-thickness skin excision after a third-degree burn injury

Burns Trauma. 2020 Jul 27:8:tkaa014. doi: 10.1093/burnst/tkaa014. eCollection 2020.

Authors

Jiro Oba¹, Motonori Okabe², Toshiko Yoshida², Chika Soko², Moustafa Fathy^{2

3}, Koji Amano⁴, Daisuke Kobashi¹, Masahiro Wakasugi¹, Hiroshi Okudera¹

Affiliations

¹ Department of Emergency and Disaster Medicine, University of Toyama, Toyama 930-0194, Japan.
² Department of Regenerative Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Toyama 930-0194, Japan.
³ Department of Biochemistry, Faculty of Pharmacy, Minia University, Minia 61519, Egypt.
⁴ Department of Emergency Surgery, Sakai City Medical Center, Sakai, Osaka 594-8304, Japan.

Abstract

Background: Severe burn injuries create large skin defects that render the host susceptible to bacterial infections. Burn wound infection often causes systemic sepsis and severe septicemia, resulting in an increase in the mortality of patients with severe burn injuries. Therefore, appropriate wound care is important to prevent infection and improve patient outcomes. However, it is difficult to heal a third-degree burn injury. The aim of this study was to investigate whether hyperdry human amniotic membrane (HD-AM) could promote early granulation tissue formation after full-thickness skin excision in third-degree burn injury sites in mice.

Methods: After the development of HD-AM and creation of a third-degree burn injury model, the HD-AM was either placed or not placed on the wound area in the HD-AM group or HD-AM group, respectively. The groups were prepared for evaluation on postoperative days 1, 4 and 7. Azan staining was used for granulation tissue evaluation, and estimation of CD163, transforming growth factor beta-1 (TGF-β1), vascular endothelial growth factor (VEGF), CD31, alpha-smooth muscle actin (α-SMA) and Iba1 expression was performed by immunohistochemical staining. Quantitative reverse-transcription polymerase chain reaction (PCR) was used to investigate gene expression of growth factors, cell migration chemokines and angiogenic and inflammatory markers.

Results: The HD-AM group showed significant early and qualitatively good growth of granulation tissue on the full-thickness skin excision site. HD-AM promoted early-phase inflammatory cell infiltration, fibroblast migration and angiogenesis in the granulation tissue. Additionally, the early infiltration of cells of the immune system was observed.

Conclusions: HD-AM may be useful as a new wound dressing material for full-thickness skin excision sites after third-degree burn injuries, and may be a new therapeutic technique for improving the survival rate of patients with severe burn injuries.

Keywords: Angiogenesis; Cell migration; Granulation; Hyperdry human amniotic membrane; Inflammation; Third-degree burn.