By ANDREW MOORE
Reporter with Silicon Hills News
How do you repair a shattered leg, a ruined ligament, or severely burned skin? The answer is both simple, and a bit morbid: You need more human parts. Various bones, tendons, and other “parts” are obtained from organ donors by procurement companies, such as San Antonio’s Bone Bank Allografts, and provided to hospitals for surgery.
This year, however, Bone Bank Allografts has begun processing new human tissues for use in skin grafts and surgeries — and you aren’t going to believe where they get it.
The tissue is called amnion, and it is the innermost membrane in a human placenta – the same tissue that has direct contact with a child in the womb. The membrane is obtained, with consent of the patient, after a C-sections is preformed. The placenta is frozen, boxed up, and sent to Bone Bank Allografts where the amnion membrane is separated from the placenta’s chorion membrane and prepared for use in their new SteriShield product.
“We actually get the tissue from caesarean sections. This is donated tissue, by the mother, and that mother has done all the screening and workup that we would do for any tissue,” Chief Technology Officer James W. Poser said.
Bone Bank Allografts is not the first company to create an amnion product, but it is one of the few leading the way. While the medical benefits of amnion have been known for the last 30 years, the tissue has only started seeing use in the last four years – particularly in ophthalmic (eye-related) use.
So what are these benefits? Amnion membranes have unique biological factors that help heal wounds without producing scars. It contains particular elements, called cytokines and growth factors, which will regulate the body’s response to trauma, infection, and inflammation – resulting in better overall healing of a wound. The tissue is dried and sterilized into a thin, flexible sheet of material that surgeons can use in a variety of applications both topical and surgical.
Amnion can be used as a wound-cover in burns, skin ulcers, and general skin grafting procedures where it helps the graft better take to the patient’s body. In corneal abrasions or burns, the membrane can be placed over an eye wound to prevent the eye from scaring and permanently blurring a patient’s vision or causing them lasting pain.
Amnion is equally useful in surgery. Dr. Richard Guyer, an orthopedic surgeon at the Texas Back Institute, has been working with amnion for over two years.
“It prevents there from being any scar tissue over the sack that holds the nerves, called the Dura,” Guyer said. “So we use a lot of these amnion membranes almost routinely to prevent scars.”
Scar tissue around nerve clusters can cause pinched nerves and result in back pain after surgery. Typical surgeries, which can benefit from amnion, include disk herniation, neck fusions, and spinal decompressions.
Amnion is also very useful in tendon and ligament repairs. By wrapping tendons, ligaments, and any other moving components during surgery, a surgeon can prevent scar tissue buildup around those components and preserve a patient’s range of motion. Restricted movement is a common issue when repairing an Achilles tendon.
“One of the problems that is going to happen is this thing is going to freeze up on you,” Poser said. “All that scar tissue is going to grab that thing and hold to it. You want to prevent that from happening. One way to do that is to wrap it in Amnion.”
While Amnion products like SteriShield will be more expensive for surgeries in the short run, the tissue will unquestionably improve quality of life for the patients, Poser said. Previously, surgeons used “fat flaps” – which were literally thin slices of body fat – to protect tendons and nerve areas.
“We have used a number of other things that have not really been satisfactory. It seems to be the best thing that we have today,” Guyer said.
Because it has only been used for a short time, there is no definitive study that proves Amnion will create any cost savings for hospitals. It does, however, seem to reduce the need for secondary surgeries as well as reduce patent pain. According to Guyer, Amnion does make follow-up surgeries easier because of the reduction of scar tissue.
“In surgery we make different sizes of openings, so if we have to go back for another reason.. ..then the dissection is much easier because the properties of the membrane prevent scaring from adhering to whatever it’s covering,” Guyer said.