Amniotic membrane wound graft is effective for difficult-to-treat ulcerations

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Amniotic membrane wound graft is effective for
difficult-to-treat ulcerations
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• Dehydrated human amnion/chorion membrane
  allografts appear to be a viable option for
  chronic lower extremity ulcerations refractory to
  standard of care therapy, researchers reported at
  Desert Foot 2014 in Phoenix, AZ.

The mean number of weeks to wound closure was
5.89 in diabetics and 5.94 in non-diabetics.
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• Dr. Laura Heath, with the Phoenix Veterans
  Administration Health System, presented results
  in 40 patients who were successfully treated with
  dehydrated human amnion/chorion membrane (dHACM)
  graft to full epithelialization.
• Study participants had undergone prior treatment
  for a chronic lower extremity foot ulcer that had
  failed to heal for at least 4 weeks after the
  start of treatment.
• Subjects underwent sharp debridement to remove
  non-viable tissue with a variety of adjunctive
  therapies including moist dressings, antibiotic
  ointments and negative-pressure therapy.

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• In prior research, dHACM has been shown to
  contain growth factors that facilitate wound
  healing including PDGF-AA, PDGF-BB, bFGF, TGF-ß1,
  EGF, VEGF, and PlGF, as well as anti-inflammatory
  interleukins (IL-1ra, IL-4, IL-10), and TIMP-1,
  TIMP-2, TIMP-4, which help regulate the matrix
  metalloproteinase activity, Dr. Heath pointed
  out.
• Follow-up in the study ranged from 4 to 108
  weeks.
• The mean wound size at the time of the initial
  dHACM application was 2.79 cm2 in the 22 diabetic
  patients, 4.96 cm2 in the 18 non-diabetic
  patients and 3.36 cm2 in the combined groups.

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• The mean number of dHACM applications was 3.36 in
  diabetics, 3.11 in non-diabetics and 3.25 in the
  combined groups.
• The mean number of weeks to wound closure was
  5.89 in diabetics, 5.94 in non-diabetics, and
  5.90 in the combined groups.

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• dHACM is 'a useful wound healing modality'
• "Given the clinical risks and high cost
  associated with treating lower extremity ulcers,
  the development of treatment strategies to
  improve healing rates and reduce healing times is
  warranted," Dr. Heath said.
• "Overall, the results indicate that dHACM is a
  useful wound healing modality for recalcitrant
  lower limb ulcers," she added.
• Jill Stein is a Paris-based freelance medical
  writer.

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