Journal Article

Novel Use of an Aseptically Processed Amnion-Chorion Placental Allograft to Complement Wound Closure in High-Risk Sternotomy Patients: Clinical Safety and Outcomes

Khalpey, Zain, Chnari, Evangelia, Khalpey, Zacharya I, Long, Marc, Kumar, Ujjawal, Hitscherich, Pamela

2024

Overview

Objectives Wound dehiscence is defined as the partial or complete separation of the layers of a surgical wound. Wound dehiscence and infections are of significant concern in the field of surgery as they can lead to a range of complications, including infection, delayed healing, increased healthcare costs, and patient discomfort. For patients at high risk of sternal wound dehiscence and infection, optimization of wound closure is critical. Novel technologies are increasingly being developed to optimize wound closure following median sternotomy for cardiac surgery. Aseptically processed amnion-chorion placental allografts (aACPA) are one such example. Placental allografts maintain the inherent growth factors and matrix proteins native to the tissue, all of which are known in the literature for their roles within the natural closure of wounds Methods Twenty-six patients who underwent cardiac surgery requiring a median sternotomy at a single center undertaken by a single surgeon were included in this study. All patients included were deemed high-risk for sternal complications and had at least one sternal risk factor. Before closure, 160 mg of aACPA was added to the sternotomy wound to support wound repair. Data were collected for rates of sternal complications, as well as general demographics and past medical history of patients included in this study, and appropriate analyses were carried out. Results At their 14- and 30-day follow-up visits, none of the patients had experienced sternal wound dehiscence or infection, with their sternotomy wounds showing excellent signs of normal wound closure. A comprehensive sternal pain evaluation was carried out, which elicited no significant pain in any patients, a sign that sternal closure was successful and stable. The addition of the aACPA into our clinical practice has also contributed to no longer requiring postoperative chest stabilization adjuncts, resulting in significant financial and resource savings for our group. Conclusions In this study, the amnion-chorion placental allograft showed promise as an effective solution to support sternal wound closure in high-risk patients. Its inherent growth factors and ECM (extracellular matrix) may directly address the specific challenges faced by these high-risk individuals. This innovative treatment offers a novel and advanced approach to support wound closure in patient populations that are particularly vulnerable to complications.

• Publisher: Cureus
• Subject: Cardiac/Thoracic/Vascular Surgery