The Polylactide membrane (PLM) is a biosynthetic dressing that mimics properties of the human epithelium. Herein we describe our experience on the use of PLM in pediatric burns. All pediatric burn patients admitted to the Pediatric Surgery Department between November 2019 and November 2021 and submitted to PLM application were selected. Clinical and demographic data were collected retrospectively. Seventy-seven patients with a median age of 1.8 years were included. The median total body surface area was 6% (2-20%), and burns were mainly mixed-partial thickness. PLM was applied at a median of 5 days post-burn (IQR 3-6), usually under sedation (43/77). After PLM application, the median healing time (HT) was 10 days (IQR 8-14). HT was significantly higher in deep-partial thickness burns vs. mixed superficial-deep (P = .015) and superficial burn areas (P = .006). No correlation was found between HT and the timing of PLM application. The grafting rate due to clinical misevaluation was 2.7%, one infection was found. The PLM is a promising way for treating partial-thickness burns, even when applied later during treatment. Shorter HT, the decreased need for dressing changes, and the potential of sparing of donor sites and pain reduction are its main advantages.

BACKGROUND: Segmental bone defects are a challenging clinical problem. In animal studies and craniomaxillofacial surgery, resorbable polylactide membrane (OrthoMesh; DePuy Synthes, West Chester, PA) shows promise for treatment of bone defects. This study presents the results of the treatment of segmental bone defects with resorbable polylactide membrane, bone morphogenic protein-2 (BMP-2), and autograft.
METHODS: This study was approved by the institutional review board. All patients with a segmental bone defect treated with a resorbable polylactide membrane by a single surgeon from 2010 to 2019 were retrospectively reviewed. Data related to demographic variables, surgical details, and union were collected.
RESULTS: Eleven patients with median age of 37 years (range 22-62 years) were included in the study with segmental bone defects in the tibia (n = 3), femur (n = 4), or forearm (n = 4). Median bone defect size was 6 cm (range 3-12 cm). Etiology of bone defects included osteomyelitis (n = 7), oncologic resection (n = 3), and post-traumatic aseptic nonunion (n = 1). Flap coverage was performed in two patients. Median radiographic follow-up was 24 months (range 5-75 months). Ten patients (10/11) achieved union at a median of 17 months (range 5-46 months). Seven patients required reoperation for any reason with six patients requiring repeat grafting.
CONCLUSIONS: To our knowledge, this study is the largest series of patients with segmental bone defects treated with resorbable polylactide membrane. Resorbable polylactide membrane in combination with BMP-2 and autograft represents a safe and effective method of bone graft containment in segmental bone defects measuring up to 12 cm in this series. Ten of 11 patients achieved union at a median time of 16 months with 6 patients requiring repeat grafting. These results compare favorably with the induced membrane technique. This study is limited by its retrospective design, absence of control and comparison groups, and low patient numbers. Future prospective randomized study of the induced membrane technique and resorbable polylactide membrane should be undertaken to determine preferred approaches for treatment of segmental bone defects.