Wound treatment has evolved considerably over the course of human history. Early attempts to treat wounds began in pre-historic times using tropical plants on open wounds, and developed to include suturing techniques using the claws of giant soldier ants. The same innovation took place simultaneously and independently on several continents.
About 200 years ago, according to Prof. Paulo Alves of Portuguese Catholic University, scientists looking to treat pressure injuries began to move in the direction of applying dressings and using technology. By 1899, medical reports were already recommending smoother and softer surfaces. That same year, the innovative ideas of cleaning the wounds (twice daily) and using water cushions to maximize softness on the wounds were also introduced.
When it comes to pressure injuries in the legs, Prof Alves says, compression therapy is the current king. This method consists of using a sock or stocking to help move blood through the body.
But there might be something even more effective on the horizon. Researchers are testing another technique that could replace or enhance compression therapy and other treatments: using amniotic membrane.
The research is not definitive... yet. But studies show promise for the treatment!
Amniotic Membrane: The Future King of PIs?
The amniotic membrane is part of the protective wall around the fetus in utero. It is the layer of the membrane that is closest to the fetus, separated from the fetus only by the amniotic fluid. It begins to form about a week after conception.
As the first line of defense for the developing fetus, it naturally contains a wealth of healing properties which has been shown to be effective in preventing contamination, reducing healing time for wounds, decreasing inflammation, and reducing the loss of water, protein, and electrolytes.
Utilizing amniotic membrane is, in fact, an old method of treating wounds that had recently experienced a revival which could soon push it to the front ranks, decades after it had first surfaced as a possible solution to burn wounds and other maladies.
While its origins in wound care are related to the treatment of burns because if its restorative power, researchers have been testing the possibility that the amniotic membrane could also be effective in chronic cases that have resisted other treatments.
The treatment consists cleaning the wound of all foreign elements and ensuring that there is no infection. The membrane is then applied directly over the wound and held in place with sterile strips.
A Brief History of Amniotic Membrane Use in Healing
While research has focused on the properties of the amniotic membrane in recent years, it is not a new discovery. In fact, it has long been a part of the medical toolkit:
- First used in a skin transplant as early as 1910
- Documented as being part of treatment of burns in 1913
- >Adopted by the field of ophthalmology by the 1940s
- It emerged as an important part of the treatment of corneal perforation and other eye surface pathologies in the 1990s.
Study of Amniotic Membrane Use to Treat Pressure Injuries
In 2016, Prof. Alves was involved in a series of five case studies to test the healing speed of wounds treated with amniotic membrane. The study group also wanted to learn more about its healing parameters, pain relief properties, and how it responds to pressure injury symptoms.
The membranes were collected from patients who had given birth through caesarean sections, with patient consent. The data on the wound treatment was collected through direct observation over a maximum period of 40 days.
The results show that 60% of the wounds tested were reduced with the treatment and all of the patients involved experienced a reduction in pain. However, due to the small sample size, this study is insufficient to draw far-reaching conclusions.
The findings show that there was no increased risk to the patient by applying amniotic membrane, which was compatible with results from other studies. Researchers have consistently found that the application of amniotic membranes have no adverse effects on the wounds and increase the chances of improvement.
The biggest challenges revealed in the study was the difficulty storing the membranes, as well as their limited availability, making it challenging to proscribe on a large scale. However, the success rate in healing the wounds and strong success in reducing pain shows the high potential for the treatment and that more research is warranted.
The Future Offers Hope
While much of the emphasis in the war against pressure injuries focuses on prevention, a potential breakthrough in treatment of wounds that can't be prevented is a welcome development.
Amniotic membrane, through its very nature, has significant potential to help pressure injuries heal. Researchers are still looking for the right way to apply the treatment and the circumstances under which it is most likely to be most effective.
In time, however, there could be a significant advance that would reduce the pain and suffering of patients suffering from pressure injuries.
Now, that would be a reason to celebrate.