Surgical oncology and reconstruction
Clinical Application of a Hyperdry Amniotic Membrane on Surgical Defects of the Oral Mucosa

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Purpose

The aim of this study was to evaluate the usefulness of a hyperdry amniotic membrane (AM), a novel preservable human amnion, as a wound-dressing material for surgical defects of the oral mucosa.

Materials and Methods

A hyperdry AM was used in the treatment of 10 patients who had developed secondary defects in the tongue and buccal mucosa after the surgical removal of cancerous or precancerous lesions. The effectiveness of the hyperdry AM was assessed by scoring its operability during the surgical procedure and by the hemostatic status, pain relief, feeding situation, epithelialization, and scar contracture in the postoperative period. Its usefulness was evaluated by considering its effectiveness and safety based on the absence of wound infection and graft rejection.

Results

The membrane was found to be easy to handle as an oral-dressing material. It adhered well to the bare connective and muscular tissues. One lingual case showed slight postoperative bleeding, which astriction then stopped. No remarkable adverse effects were observed in the process of wound healing. The average score of the patients was 11.2 points (10 to 13 points) in the present evaluation, with 14 being the highest possible score.

Conclusions

This study showed the clinical usefulness of the hyperdry AM as an intraoral wound-dressing material. Although the number of cases was small, the results suggested that the hyperdry AM is biologically acceptable to oral wounds and could be a suitable clinical alternative for the repair of the oral mucosa.

Section snippets

Materials and Methods

The hyperdry AM was prepared as follows. Fresh human amnions were obtained with the consent of donors who were seronegative for syphilis, human immunodeficiency virus, human T-cell lymphotrophic virus type 1, and hepatitis B and C viruses and who were scheduled to undergo cesarean section at Toyama University Hospital. The collected amnions were washed with sterile phosphate buffered saline without removing the epithelial cell layers. They were then dried under consecutive far-infrared rays and

Results

The hyperdry AM is a semitransparent thin membrane. In the dry state, it possesses morphologic stability and therefore is easy to shape with scissors. Upon hydration, however, it thickens and becomes flabby, and its transparency increases. It is known that the histologic structures of hydrated hyperdry AM are similar to those of fresh amnions (Fig 1).

The mean follow-up period after the use of the hyperdry AM was 20.9 months (range, 3 to 36 mo). This study included 10 patients 54 to 89 years

Discussion

Raw wounds of the oral mucosa, like any other wound, generally heal by granulation and after epithelialization. It is known that the incidence of infection and the degree of contraction caused by scarring are decreased when wounds are covered by biological materials rather than uncovered or covered by nonbiological materials.24, 25, 26, 27 Thus, biological coverings that remain stable for an adequate time may be useful for wound healing. Unlike other organs such as the skin, grafts to oral

References (35)

  • K. Kitagawa et al.

    A hyperdry amniotic membrane patch using a tissue adhesive for corneal perforations and bleb leaks

    Am J Ophthalmol

    (2009)
  • J. Nanchahal et al.

    New grafts for old?A review of alternatives to autologous skin

    Br J Plast Surg

    (1992)
  • C.N. Bertolami et al.

    Healing of cutaneous and mucosal wounds grafted with collagen-glycosaminoglycan/silastic bilayer membranes: A preliminary report

    J Oral Maxillofac Surg

    (1988)
  • B. Sezer et al.

    Comparison of autogenous mucosal grafts and collagen-based, solvent-preserved allografts for vestibuloplasty

    Quintessence Int

    (2004)
  • T.E. Bie et al.

    Split thickness skin graft for vestibuloplasty operations

    Int J Oral Surg

    (1986)
  • Z. Danilewicz-Stysiak

    Use of a fibrin membrane in the practice of mucosa tests

    Rev Stomatol Chir Maxillofac

    (1968)
  • M. Kalkowska et al.

    Trials of using chitin and its derivatives in medicine and pharmacy

    Czas Stomatol

    (1990)

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