Pediatric Trauma Society

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Using Dehydrated Amniotic Membrane Skin Substitute In Facial Burns: Is there an Outcome Difference Between Adults vs Pediatric Patients?
Salomon Puyana, MD, MS; Adel Elkbuli, MD, MPH; Brenda Benson, RN, CEN; Eileen Bernal, MD; Mark McKenney, MD, MBA; Morad Askari, MD, MBA; Haaris Mir, MD
Kendall Regional Medical Center, Miami, FL

Introduction: Facial burns have significant physical and psychological effects on patients. Advancements have allowed the development of various skin substitutes. Among these, human dehydrated amniotic skin substitutes represent novel technology, yet their outcome has not been sufficiently studied. The objective of our study is to compare the benefits of amniotic membrane skin substitutes in treating adult and pediatric facial burns.Study Design and

Methods: A retrospective review of our institutional burn registry; a total of 90 burn patients met study inclusion criteria. Demographic and outcome measures included age, %TBSA, Injury Severity Score (ISS), complications (pigmentation, hypertrophic scar, infection, and healing at two-week post-operative). Paired sample t-test and Chi square analyses were used with significance defined as p<0.05.

Results: Seventy-seven adults and 13 pediatric patients with facial burns that received amniotic membrane skin were included in the analysis. The mean age for adults was 40.8 years compared to 5.6 years for pediatrics. Mean TBSA was similar, with 9.6% (1-57%) in adult compared to 6.0% (2-14%) in pediatric patients. The mean ISS was not significantly different between the groups (4.0 versus 2.2, p=ns). Pediatric patients with facial burns treated with amniotic membrane had a higher incidence of dyspigmentation as compared to the adult patients (46.2% vs. 9.1%, p≤0.05). Remaining morbidities were not significantly different between adult and pediatric patients. All patients in both groups healed by the second postoperative week.

Conclusion: Use of dehydrated amniotic membrane skin substitute can produce similar benefits in the treatment of adult and pediatric facial burns.

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