557 Amniotic Fluid Injections in Chronic Non-Healing Wounds in Pediatric Patients: A Case Series
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".