From the Winner’s Circle: How Amnion Is Changing Wound Care LIVE at Magnet & Pathway 2026

[00:00:09] Hello and welcome to the Nurse Rosa's INsights. I'm your host, Rosa Hart, coming to you live from the Magnet and Pathway Conference in Chicago, Illinois. And joining me today are the Magnet Prize winners from Toronto, Canada. Who even knew? Magnet is like international, but it really is. So we have Nellie Amaral and we have Anna Kaa. And this innovation is blowing my mind.

[00:00:39] You guys walked across the stage last night and got to accept this award, which gives you some money to further it. But tell us, should we start with Anna? Like, did you kind of instigate this whole program? Is that what I heard? Yeah. Well, thank you for that question. And thank you for having us at your podcast. We're really excited to be here to represent our organization. Actually, our story is one of a very inspiring story. It actually started out with our nurse practitioner in wound care.

[00:01:08] She was our clinical lead, who was one of the brainchild of this whole program in collaboration with our tissue bank, as well as one of our head surgeon in ENT. And they embarked on this journey in terms of like discovering, hey, there's this unused placental tissue that is filled with a lot of growth factors and protein that can help support fetal development. And that byproduct of a placenta are usually discovered.

[00:01:38] And at Mount Sinai Hospital in Toronto, we have a huge like women's and infants program, which I'm sure Nellie will be able to touch more on. But based on that, we were able to create a program called Mothers Healing Others. And that's where we collaborate with tissue bank as well as our surgeon to consent for those tissue donation. Laura Mary Teague was actually one of our mentors. She was my mentor and she led me into becoming who I am in terms of being a clinical nurse specialist, APM wound care.

[00:02:07] Unfortunately, we sadly lost her in a couple of years back. Sorry, a little emotional. Every time we call out Laura's name. Yeah, I know she's watching. I'm very proud of us. But I actually met her at another organization where she actually led me to become a more specialized wound care professional. And at that time, I was a critical care nurse. And I adore everything that she did when it came to wound care.

[00:02:36] Everything she touched magically became a legacy in itself. And as we began to hear more about Amion and how it came about, I was actually a clinical nurse specialist in the ICU at Mount Sinai. And she always loved to come into our office and be like, hey, Anna, come, let me show you what we're doing right now. And Amion was actually one of those tissues that she brought into the ICU and was able to apply it over a surgical neck incision.

[00:03:04] And immediately over a course of a couple of weeks, it achieved complete wound healing with little to no scarring. And it actually sped up healing than what we normally would have seen with a conventional wound dressing. So Amnion, we discovered, is actually a very powerful tissue. It has anti-inflammatory properties.

[00:03:24] It helps reduce pain, especially in our patients, a population that does injure a lot of discomfort, a lot of post-surgical pain, also related to radiation therapy. So it helps alleviate a lot of that as they tend to achieve greater healing, as well as it's anti-scarring.

[00:03:43] And there's also some potential for immunological support, especially when it comes to the immune system in patients who are semi-compromised as well. So Amion is what we call like a magical tissue. And right in front of our eyes, we're able to witness this wound closure within a couple of like six to eight weeks time frame.

[00:04:09] And a lot of our patients that we started Amion on was for head and neck surgery, post-squamicelle carcinoma resection, where they have to do like a lot of mandible reconstruction and repair. Sometimes they do develop like salivary fistulas, where wound healing is almost non-achievable.

[00:04:30] And a lot of times they do develop a lot of like something we call eschar, which is think of like a scab just at the below of your neck and it's very visible. And if we don't involve like an expertise such as ourselves or even with the surgeon's help to help remove that scab surgically or even something we call conservative sharp debridement, where we remove that like non-viable tissue that doesn't achieve healing.

[00:04:57] If we don't intervene in that process, that wound tends to stay open. And the patients do report that they have a sense of discomfort, a lot of pain associated with it. And fortunately, we were able to intervene. I don't know if you want me to talk about like the process of how we get involved, but... I should probably... Yeah. I do, right? Yeah. Yeah. Yeah.

[00:05:24] But yeah, it's pretty cool in terms of like wound healing. Amnion is amazing. Yeah. I'll leave that to Nellie. So, Nellie, I believe you're the program director, right? I'm the vice president. That's why they told me you're the program director. So you're the magnet program director.

[00:05:40] So, Nellie, can you share with us about what it was like to bring this program up to, I guess, the system to get approval and then to coordinate that in a multi-specialty situation? Whether or not it's nurse-led, it's not only nurses you've got to coordinate with, right? So can you speak to that interdisciplinary collaboration? Absolutely. Thank you, Anna. It started with a vision.

[00:06:06] It started with Dr. Laura Mary Teague, an academic lead in wound care and a nurse clinician, a nurse practitioner. She came to me with a vision saying, we already have this product through Mothers Healing Others in our Women's and Infants program where mothers donate.

[00:06:25] Mothers who have a planned C-section review some materials and they consent and they agree to donate their amniotic membrane to help others heal wounds, hence Mothers Healing Others. It's processed and prepared in our own hospital in our tissue and bone bank.

[00:06:45] And she had a vision to say, I'd like to try this product on a few patients, monitor, watch, in collaboration with our physician team, in support of our executive team and say, let's see what happens. It's Health Canada approved. It's approved for human use.

[00:07:05] And so we decided that we were going to put together an executive report and present to our CEO and to our chief nurse and to our professional practice. And we said, this is our vision. This is what we'd like to do. Engaging and collaborating with our tissue and bone bank, our physician group, and of course, all of the clinical areas that were inspired as our initial trial.

[00:07:33] We started off with five patients. It didn't take very long to see how successful this was. I would dare say that it was life-changing for many of our patients, experience for our patients and their families. We trialed on both an inpatient and an outpatient.

[00:07:55] And where difficult or impossible to heal wounds, we're being healed to full closure within weeks. The application process is very simple. It requires diligence. It requires expertise. But the maintenance and the recovery is so much simpler than your current wound therapies. And it just worked. And it just made sense.

[00:08:24] So then a few weeks later, a few months later, we went back with our little presentation back to the executive team and showed before and after pictures. And then we asked for approval to move forward with this as a permanent line of therapy in our organization, which is what we've done.

[00:08:42] What our wound care team has done in collaboration with our physicians, our bone bank, bone and tissue bank, nursing colleagues, clinical nurse specialists, nurse managers, families, patients and families. We have materials that were prepared for patients and families to explain what procedure they're about to have on them. And it's really not a procedure. It's a wound care treatment.

[00:09:10] It's very non-invasive at all and non-painful. So that's how the vision started. That's where we started from with a nurse vision, a nurse initiative, a nurse innovation, clinically based, clinically researched in collaboration with our bone bank. And we said, let's try it. That is amazing.

[00:09:34] And even though it's non-invasive, anytime you're having biologicals from one person that you're given to another, you're talking about the processing that goes into that. And, you know, just like when we donate blood, there's safety considerations. You want to make sure you're not giving anybody any new germs. And then maybe you could speak to the any rejection type issues that might come up.

[00:09:57] Or if you're treating someone who's been treated for cancer and they're immunosuppressed, like if there are special considerations for that. Well, thank you for that question. We do get asked about does a patient need to be something similar to like giving or receiving blood products to be cross-matched with the amnion? And the answer is no. The reason for that is because amnion allograft membrane, when tissue bank receives it, they clean out the DNA, they clean out the blood, they clean the tissue.

[00:10:27] And then they would test it and then treat it and preserve it. So we basically treat it like a wound dressing without any need for DNA testing or any of sort because it's all cleared of that. In terms of like rejection, I know we get that question from our patient and family as well. I wouldn't call it a rejection, but what we do see is a potential for infection because we are introducing something that is foreign.

[00:10:54] Similar to as if we were to introduce the type of dressing or along the way, we're cleaning it with like a gauze or something in the environment that can transfer onto the wound itself. But amnion is not known to cause any rejections from the patient receiving it. At most, we do explain to the patient that there is a risk of infection showing up.

[00:11:18] But sometimes we can't deduce it to just amnion, but sometimes it's the patient who already has an underlying chronic infection that we're actively treating with lifelong antibiotics. And we do preemptively provide that patient teaching education to let them know what the clinical signs and symptoms look like. So it's like your typical fever chills. Although they may not respond the same way, if they've undergone like radiation therapy, they may have some feeling of unwell.

[00:11:47] We will see discharge that is like a yellow greenish color or pus, like the consistency of pus. Then that's when we would ask them to come back to us immediately, seek medical treatment, and then we'll definitely pause the treatment for a couple of weeks.

[00:12:04] Have them be started on antibiotic if they aren't already on it, and then treat the wound locally with a conventional dressing while managing the wound bed prep before we decide if they're safe for us to start amnion again. Thank you. And so this magnet prize is not just a trophy to put on the shelf. It's $100,000 to go towards these efforts.

[00:12:27] So Nellie, can you tell us what difference that's going to make and what you're going to be able to do with a program that that will empower you to do? Thank you. We're looking forward to working with this $125,000 for the magnet prize sponsored by Qualtrics and Prescati. And we have a lot of plans for it. And for example, we want to further advance our evaluation of the product.

[00:12:55] We've applied for research at the board research. We want to understand and do a retrospective study on all 140 patients that we've already had. We want to be able to expand the program in its current format to different clinical areas. This requires education. This requires devices. This requires support from our tissue and bone bank.

[00:13:23] Right now, a lot of the product is in kind. And eventually, we're going to need to be able to make sure that we have sufficient funds to continue this therapy. We want to expand not just within our hospital, but across Canada. We want to be able to present at conferences. We want to celebrate this work. And most importantly, if we don't have the product, then we can't advance the work.

[00:13:52] So we also want to see how we can optimize our Mother's Healing Others program and get support to make sure that we have a donated amniotic membrane. And would it be possible to get donated membrane from a birth that's not a C-section? So I think currently, we're looking at planned Caesarean section because it's easier to control the external factors and prevent the contaminants that comes with the vaginal birth.

[00:14:21] It's easier for the tissue mite to test with a donated C-section that's done in a sterile operating room setting. So the likelihood of that amniotic membrane doing well in terms of processing, testing, preservation especially for use is much cleaner process. And I believe that's the route that we chose for when it comes to Health Canada approval is to have donated C-section.

[00:14:47] And with that said, it's not to say that it's not likely that we could do that, but maybe in a different way of use, we could evaluate that. But of course, it's not to say it's not impossible. Well, just because you were talking about needing more to work with. I mean, there's plenty of people who have wounds that need the treatment right. So I was just wondering, will that expand the ability to get those donations? Right, exactly.

[00:15:13] So right now, we have a very large women's and infants program at Mount Sinai in Toronto. And it's an in-house product retrieval, product preparation, and product application. If we expand this program eventually over time, we may be able to expand this across Ontario for additional donors. All right, last question. You're the clinical nurse specialist. So what do you wish every nurse knew about wound healing?

[00:15:43] About wound healing. So the realm of wound healing, what I learned from my mentor, Laura, is that it's an art and science in itself. You can never just look at the wound and determine that's what defines our patient that we look at. There's more to it in terms of like the background story of the patient. There's reasons as to why we're seeing a wound. In terms of chronicity, we're looking at a time frame of during that period, why did it not heal?

[00:16:11] What were the contributing factors that along the way we could improve and work on? So whenever I see a patient that comes in with a wound, I don't just look at the wound. I look at their past medical history. I look at why they developed the wound. What was the controlling factors? And is there something along the way that we can optimize to ensure that they do achieve wound closure? Whether it could be as well as collaborating with our interprofessional health members, such as our dietician, our physiotherapist,

[00:16:40] but also really getting our nurses who are taking care of these patients to understand why that wound is so important in terms of the patient's quality of life. And what kind of lasting impact we want in terms of treating and managing the wound, because a lot of times it's associated with pain, appearance, insecurity, and then also debilitating. Because some of the patients, depending on where the wound shows up, can really limit their daily lives of activity.

[00:17:09] And a lot of times these patients, they don't just come in with the wound. And they come in with a lot of other psychosocial factors that we also have to consider. So that's where I really lean on my counterparts, my colleagues, including social work and including our pharmacists, our physicians. I think as a wound care leader, it's really important to lean on everybody as a wound care team to help provide the excellent quality of care that they deserve,

[00:17:36] that we have resources to. And especially with Amnion now is our innovation, one of our key tools that we can reach for in adjunct to everything else that we can offer. Well, that is beautiful. And I love this example of interdisciplinary collaboration and cooperation. So thank you for leading the way in this. I'm so glad you're getting some recognition for it. And I can't wait to see where it goes from here. And if it spreads across Canada and the United States and the rest of the world, then that'll be amazing.

[00:18:06] So stay tuned for more from the Magnet and Pathway Conference and find out the amazing conversations and nurses that are innovating that are here. And we'll hope to see you here next time.