Burns, non-healing wounds and pressure sores cause extensive damage to the skin leading to infection and loss of precious body fluids. Despite advances in burn management the mortality rate continues to be high and the search for an economical and easily available dressing to control burn wound infection continues. Autologous skin has limited availability and is associated with additional scarring. Conventional dressings require frequent changes which can be painful and may even require anaesthesia. Amnion is an excellent biological dressing and its use in the treatment of burns has special appeal in India as there are religious barriers to the acceptance of bovine and porcine skin.Lyophilised, irradiated amnion provided for the first time in the country by the Tata Memorial Hospital Tissue Bank was evaluated as a temporary biological dressing. It was used to treat 35 patients with burns, 21 patients with bedsores and non-healing ulcers and the skin graft donor sites of 11 patients. The amnion was easy to handle and stuck well to the raw wound bed. An open dressing was used in most of the second degree burns which healed with hyperemia and early pigmentation. In patients with third degree burns, ulcers or skin graft donor sites, closed dressings were used. The exudate and induration were reduced and patients were more comfortable and experienced less pain. There was healthy granulation with good re-epithelialisation. Amnion was not used in patients with infected third degree burns.

The purpose of the present study was to clinically and radiographically evaluate and compare the efficacy of demineralized freeze dried bone allograft (DFDBA) and bovine derived xenogenic bone graft (BDX) [Bio-Oss] with amniotic membrane (AM) as guided tissue regeneration (GTR) in the treatment of human periodontal Grade II buccal furcation defects. Ten patients suffering from chronic periodontitis, displaying bilateral Grade II buccal furcation defect, were randomly treated using DFDBA with AM (Experimental site A) or using bovine derived xenograft (BDX) with AM (Experimental site B). The clinical and radiographic parameters were recorded at baseline, 6 and 9 months. Healing was uneventful in all patients except one site which was treated with BDX + AM. At 9 months after therapy, soft tissue measurements for the DFDBA + AM group showed pocket depth (PD) reduction of 4.7 mm +/- 0.58, and relative attachment level gain of 4.8 mm + 0.32, while the BDX + AM group showed a PD reduction of 4.4 mm +/- 0.27, and AL gain of 5.1 mm +/- 0.09. Osseous measurements showed bone fill of 2.1 mm +/- 0.36 for the DFDBA + AM group and 2.43 mm +/- 0.38 for the BDX + AM group. Percentage gain in bone was 76.3% for the DFDBA + AM group and 79.6% for the BDX + AM group. Statistical analysis revealed there was no statistical difference between the two materials in all measurements. Within the limits of the present study, it can be concluded that: (1) at 9 months after surgery both therapies resulted in significant PD reductions and CAL gains and (2) significant improvement was seen in bone fill and percentage gain with both the material, however, there was no significant difference between both.

The availability of safe and reliable, banked tissues in India has enabled the use of human bone allografts as a viable alternative to autografts in reconstructive surgery. Lyophilised, irradiated bone grafts were used in 2 cases of rhinoplasty, a case of hemifacial atrophy, and as a chin implant.In the patient with revision rhinoplasty the rib graft was resorbed. The patient with hemifacial atrophy developed seroma and infection in the zygomatic and infraorbital area and the rib graft had to be removed. The graft from the same rib that was placed over the mandible was retained well and incorporated completely. The iliac crest cortico-cancellous grafts did well in the second case of augmentation rhinoplasty and in the augmentation of chin.The primary objective of reconstructive surgery in the treatment of burns, non-healing wounds and pressure sores is to remove the dead tissue and restore the continuity of the skin without delay. Lyophilised, irradiated, human amnion is a temporary biological dressing conveniently available off-the-shelf. It was used in twenty four patients with burns, eight patients with bedsores and six patients with non-healing ulcers mainly on the foot. The total surface areas of burns sustained were from 2% to 40%. The burns ranged from second degree to deep third degree burns. Amnion was not used in patients with infected third degree burns.The amnion provided good biological cover in all the patients. It was easy to handle and apply, and provided pain relief. The duration of healing varied depending on the extent and depth of the wound and the amount of exudate. The superficial bedsores healed with a single application of amnion. Reduced exudate, healthy granulation tissue and enhanced epithelisation were observed following application of amnion.

Demineralised, freeze-dried bone allografts (DFDBA) have been used extensively by dentists in the treatment of periodontal and periapical osseous defects resulting from inflammatory diseases. Their use in India however, is limited by the availability of quality allografts and the high cost of imported alternatives. A study was conducted to assess the osteogenic potential of DFDBA prepared for the first time in India by the Tata Memorial Hospital (TMH) Tissue Bank. The DFDBA was used in the treatment of osseous defects after removal of periapical lesions associated with devitalised teeth in 10 healthy patients. At the 6-month recall visit all the patients showed a remarkable decrease in the grades of mobility, and 9 out of the 10 patients showed radiographic evidence of complete healing of the osseous defects with evidence of normal bony trabaeculae. These findings indicate that the indigenously prepared DFDBA is a cost effective, biocompatible material with osteogenic potential that can be used effectively in treating osseous defects of periapical lesions associated with non vital teeth.

The management of moist skin desquamation (ulceration) following radiation therapy has been a concern since the inception of this therapy. The treatment of skin reactions focuses on promoting healing, improving patient comfort preventing infection and decreasing trauma to the area. Various dressings like topical preparations, hydrocolloid and gentian violet 1 % dressing have been used for its treatment. We present our experience with the use of amnion as a biological dressing in patients with radiation induced ulceration following pelvic radiation using megavoltage beam. The preliminary experience with treatment in 14 patients proved to be cost effective due to a shorter duration of ulcer healing (median of 7 days), fewer dressing changes (median of 4 dressings) and diminished use of analgesics.