Aseptically Processed Dehydrated Allograft Placental Membrane for Incisional Management Prior to Surgical Closure
Speaker: Michael N. Desvigne, MD, FACS, CWS, FACCWS
Introduction:
Surgical site infections represent a significant economic burden of the US Healthcare dollars spent 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.
Method
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.
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 tis-sue without terminal sterilization is known to maintain the inherent growth factors and native matrix proteins, which support 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.
