References
Amniotic and umbilical cord particulate in the management of keloid and hypertrophic scars
Abstract
Objective:
To examine the efficacy of using amniotic membrane and umbilical cord products in the management of keloid and hypertrophic scars.
Methods:
A single-centre, retrospective case series of patients who developed keloids or hypertrophic scars (size range: 3–30cm). Each patient had their keloids excised or hypertrophic scar debrided followed by application of amniotic membrane and umbilical cord particulate matrix and/or amniotic membrane and umbilical cord membrane. Wounds were then closed primarily and wound healing was evaluated.
Results:
All eight patients (one male, seven females) presented with keloids or hypertrophic scars that had not healed for 30.6 months. The scars were excised resulting in an average wound size of 16.3±14.2cm. After amniotic membrane and umbilical cord treatment, patients demonstrated complete wound healing in <3 months with superior aesthetic outcomes. All patients healed with minimal or no scarring and no recurrence of keloid. There were no complications, such as infection or dehiscence.
Conclusion:
This findings of this limited study suggest these immunomodulatory products could be used in a variety of wound care applications. The role of these products in chronic wound management is still evolving. Larger, high-quality studies are needed to consistently demonstrate the efficacy of these products.
When skin undergoes an abnormal wound healing process following deep skin injury, pathological scars such as keloids and hypertrophic scars can arise, resulting in a fibroproliferative disorder of the skin.1 The scars are commonly red and elevated and have an unappealing appearance that may result in limited function if overlying a tendon or joint, have a sociopsychological impact on the patient, and reduce their quality of life (QoL). These scars are also known to be associated with severe pain, itching and contraction sensations and frequently occur in people with darker skin, being 15 times more common than in those with lighter complexion.2,3
Historically, several methods and procedures have been proposed to either decrease the size of these scars or potentially achieve a more cosmetically acceptable scar such as surgical excision, intralesional steroids, antihistamines, cryotherapy, laser removal, radiotherapy and immunomodulators. However, the success of these methods has been variable.4
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