557 Amniotic Fluid Injections in Chronic Non-Healing Wounds in Pediatric Patients: A Case Series
Notice bibliographique
Résumé
Abstract Introduction Amniotic tissues are used to support wound healing in a variety of fields and wound types including chronic stasis ulcers, lower extremity wounds in diabetic patients, poorly healing injuries associated with burns, and surgical wounds associated with intestinal fistulas. To date, the use of amniotic fluid (AF) alone has not been described in the literature. The properties of AF alone would suggest the potential for regenerative and accelerated healing. This descriptive, retrospective review evaluates the effects of AF injected into chronic, poorly healing burn wounds. Methods We conducted a retrospective chart review across five years and identified a total of 39 pediatric patients with chronic, poorly healing burn wounds, nine of whom were treated with AF injections. Five of these patients were excluded due to incomplete post-treatment data. All patients were managed in the ambulatory care setting. We evaluated Vancouver Burn Scar Scale (VBSS) and Patient and Observer Scar Assessment Scale (POSAS) scores as well as pre- and post-treatment photos of the wounds. Results Four patients aged 1–16 years met inclusion criteria with TBSA ranging from 1% to 57.5%. All patients tolerated the procedure well and none suffered adverse events associated with treatment. The average time from injury to treatment with AF was 14 months. Patient A is a 1-year-old male with bilateral posterior thigh wounds that remained open following skin grafting of a 57.5% TBSA injury who received injection of AF 5 months after injury. One month after treatment with AF injections, both posterior thigh wounds were closed (Figure 1). Patient B is a 9-year-old male with posterior thigh wounds that remained open following grafting of an 8% TBSA injury who received an injection of AF 10 months after injury. Following injections with AF the wounds closed over a period of 6 months (Figure 1). Patient C is a 10-year-old female with extensive contracture scarring across the upper torso, bilateral axilla and neck from a 25% TBSA injury who received an AF injection at 37 months post-injury. Areas of open wound in the axilla closed following a combination of laser treatment to scar areas and AF injections. Patient D is a 16-year-old female with 1% TBSA injury to the posterior thigh treated with split thickness skin grafting that failed to close. Following injection with AF four months after injury, the wound closed over a period of 3 months (Figure 1). VBSS scores and POSAS scores did not significantly correlate with wound healing observed. Conclusions Injection of amniotic fluid is a low-risk treatment adjunct that can be used to improve chronic burn wounds.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,002 | 0,002 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».