(CS-146) Use of Ultra-Thick Amniotic Membrane Allograft in the Wound Management of an Open Humerus Fracture
Thursday, May 16, 2024
7:30 PM – 8:30 PM East Coast USA Time
Introduction: The management of distal humerus fractures is challenging and technically demanding due to the anatomical complexity and the multi-fragmentary pattern of injury. Despite the evolution of surgical techniques, up to 44% of patients have post-operative complications including delayed wound healing.1-7 Cryopreserved amniotic membrane (AM) derived from the umbilical cord has been increasingly used in both surgical and wound management to reduce complications and improve healing due to its inherent anti-inflammatory and anti-scarring properties.8-10
Methods: A case report of a patient who was treated with cryopreserved, ultra-thick AM allograft† for an open humerus fracture. In brief, the patient underwent open reduction and internal fixation (ORIF). Three days later, the open wound was debrided followed by application of the AM allograft† (8x3 cm) with staples over the open wound. Dressings were changed every ~3-4 days but no additional wound treatments were required throughout the course of healing.
Results: A 34-year-old female (non-smoker) involved in a motor-vehicle accident presented with an open humerus fracture (Grade IIB) on the dominant arm. Three days following ORIF, the patient received wound management for a large, complex open wound (6x4 cm, 24cm2). Following debridement, the wound increased in size to 36cm2 (9x4 cm), and an AM allograft† was stapled over the wound. Robust granulation tissue and epithelialization around the wound’s edge were noted 18 days later, with a residual amount of AM tissue noted in the central wound base. By 5.5 weeks, the wound significantly reduced in area by 99.3% (0.5x0.5 cm), and the base of the wound was flush with the edges. Complete epithelialization was noted at 8 weeks with minimal scarring. Furthermore, the patient demonstrated full range-of-motion in the arm without physiotherapy.
Discussion: The use of ultra-thick AM allograft† was shown to support wound closure for a traumatic, complex open wound and aid in functional recovery as demonstrated by complete return of ROM.
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