Case Series/Study

(CS-035) Aseptically Processed Dehydrated Allograft Placental Membrane for Incisional Management Prior to Surgical Closure

Co-Author(s):

Krista Bauer, RN, WCC, OMS,; Kari Day, RN, BSN, WCC; Ashley Wardman, CPPM, Surgical LPN-C

Introduction: Surgical site infections represent a significant economic burden of the US Healthcare dollars spend per year. When these complications occur, they result in additional hospital stay and cost. Incisional dehiscence and or infection may occur singularly or simultaneously. Surgical reconstruction of chronic wounds using complex closure techniques and/or soft tissue flaps is a routine approach to achieve closure, and such complications are not uncommon.
Placental allografts are frequently used in the management of chronic wounds, specifically to provide native matrix proteins and encourage wound progression. Incisional management following closure of chronic wounds may benefit from the addition of aseptically processed dehydrated allograft placental mini membrane to assist in optimizing the tissue for surgical healing and assist with reducing the risk of post-surgical complications at the incision site. Methods: We present 5 cases of incisional management utilizing placental allograft as a mini matrix prior to closure of surgical reconstruction (lower extremity, knee n=2, Abdomen, n=3) where placental tissue was utilized. The dehydrated placental mini membrane was placed prior to incision closure. Negative pressure was applied postoperatively and continued for 7-10 days.
Primary healing was achieved in all 5 cases without postoperative infection and/or surgical site dehiscence. Results: Primary healing was achieved in all 5 cases without postoperative infection and/or surgical site dehiscence. Discussion: The addition of dehydrated allograft placental mini membrane without terminal sterilization to surgical reconstruction may improve surgical outcomes. While the exact mechanisms are not known, the aseptically processed placental tissue without terminal sterilization is known to maintain the inherent growth factors and native matrix proteins, which supports wound closure. We found that surgical outcomes were improved with a reduced incidence of post-operative complications well below the reported 25-58%. 
In this case series, we observed improved primary surgical success with the addition of aseptically processed placental matrices intraoperatively at the incision site. Trademarked Items: *Salera Mini membrane (Placental allograft)

(MTF Biologics) References: References
1. Tran BNN, Chen AD, Kamali P, Singhal D., Lee BT, and Fukudome EY. National perioperative outcomes of flap coverage for pressure ulcers from 2005 to 2015 using American College of Surgeons National Surgical Quality Improvement Program. Archives of plastic surgery 2018 45(5), 418.
2. DiDomenico LA, Orgill DP, Galiano RD, et al. Use of an aseptically processed, dehydrated human amnion and chorion membrane improves the likelihood and rate of healing in chronic diabetic foot ulcers: A prospective, randomized, multi-centre clinical trial in 80 patients. Int Wound J 2018; 15: 950-957.