SELLERSVILLE, Pa. -- Debbie Diehl orders about 10 placentas each week from the Grand View Hospital delivery room. They are used as living bandages.
The nurse prepares the amniotic sacs -- in which fetuses float during gestation -- to be used to treat burns, skin ulcers, bed sores, or open wounds of patients at the hospital in this small Bucks County borough.
'I won't treat a burn patient with anything except amnion. It's far more superior than anything else that is available,' said Dr. Andrew B. Walker, an Allentown, Pa., pediatric surgeon who received a private grant to start a bank of the fetal material for hospitals in the Lehigh Valley area.
Because amnion, the thin, transparent lining of the amniotic sac, is a living membrane, it creates a nearly normal environment over a wound that allows it to heal faster, Walker said.
'When applied to a fresh burn, amnion causes almost immediate cessation from pain and protects against protein loss and infection,' Walker said. 'In the pediatric age group, it minimizes the chance of scarring and the necessity of skin grafting.'
Non-biological dressings often prevent the phagocytes -- cells that destroy germs -- from returning to the circulatory system, Walker said. The dead phagocytes form pus on the surface of the wound.
By creating a normal environment, the amnion allows the phagocytes to return to the body's circulation and the wound heals faster, Walker said.
The first medical article on such use of amnion appeared in 1911, but it wasn't until 1971 that the fetal material's value in curing burns gained national attention.
In 1979, a private Allentown trust fund awarded Walker $3,235 to set up an amnion bank so area doctors could get experience using the living bandage without cost to the patients. Last year the amnion bank received $4,961 more.
'I'm hoping that we'll be able to have the procedure worked out so that it's easy enough and available to everyone,' Walker said. 'If it's used it could save an enormous amount of money and suffering every year in this country.'
The amnion lining is removed from the placenta, sterilized in saline and penicillin, and then is refrigerated to wait for a patient.
Burn patients treated with amnion don't need to be hospitalized as frequently, Walker said, and patients can pick up test tubes of amnion and apply it themselves. The transparent lining allows doctors to inspect the wound without disturbing the dressing.
Pig and cadaver skin, typically used to graft severe burns, are inferior to amnion because they are expensive and often produce an antibody reaction that causes the body to reject the graft, Walker said. Amnion does not produce such a reaction and unlike other grafts, it can be applied to infected skin.
Delivery rooms, of course, can supply the fetal lining. The preparation process for the amnion costs $5 per square foot -- enough to treat ten patients with smaller wounds, Walker said. The amnion can be stored for six weeks.
'We are using it quite a bit for (skin) ulcers on outpatients since they can come pick it up and put it on themselves at home,' Ms. Diehl said. 'The patients seem pleased with it.'