What should surgeons consider when choosing wound closure and healing solutions to attain the best surgical outcome?
Recent advances in the scientific understanding of the physiology of wound healing, substantiated by clinical data on the benefits of the presence of natural healing factors, has resulted in a trend toward the use of biologic wound coverings. Amniotic tissue and human allografts provide biological wound covers for a variety of applications in both acute and chronic wounds.
Amniotic tissue is a thin and pliable biologic membrane that can be wrapped around tissue or placed as an overlay cover. Acting as a protective barrier, the membrane allows the surgical site to heal properly. Derived from scheduled and serologically screened Cesarean sections, the sterilized tissue is stored at room temperature and available in a variety of sizes to meet most surgical needs.
Allograft skin has a long history of successful clinical use. Since its introduction in the early 1970s, partial thickness allogenic skin has been a standard of care for burn and wound therapies. Partial thickness skin grafts utilizing 1:1 meshed human skin that has been processed to preserve cellular structure, innate proteins, collagen, glycosaminoglyans (GAGs), cyokine mediators and growth factors contribute to an accelerated healing process and increase patient comfort when applied to a properly prepared wound bed.
The clinical benefits of allograft skin include:
- Promotes wound bed granulation and vascularization
- Reduces electrolyte, heat and protein loss
- Minimizes bacterial proliferation to reduce risk of infection
- Diminishes wound pain
Among characteristics to look for in skin used for grafts:
- Pliable and stretchable for ease of handling
- Can be sutured or stapled without tearing, or
- Can be tacked, glued or secured with a non-adherent material
- Easy to orient, with shiny dermal side to facilitate placement
New, enhanced processing and sterilization technologies are leading to continued improvements in the development and availability of biologic wound coverings.