Dehydrated Amniotic Membrane Allograft Promotes Healing Of Complex Wounds
Melody Bedrossian, B.S., David Pougatsch, MD, Cristiano Boneti, MD, Som Kohanzadeh, MD.
Wound Institutes of America, Cedars Sinai Medical Center, Los Angeles, CA, USA.
PURPOSE: Human Dehydrated Amniotic Membrane Allograft* (DAMA) has successfully been used to regenerate tissue following injury. The objective of this study was to determine the efficacy of amniotic membrane in promoting healing and tissue growth in chronic wounds.
METHODS: Sixty-two wounds in thirty-eight consecutive patients (males n=19, 50%; females n=19, 50%) with an average age of 69 (range: 39-99) were treated in a multi-disciplinary setting with amniotic allograft for complex wounds throughout of body. Patients were evaluated weekly for an average period of 6 weeks (range: 1-71) in accordance with standard of care (SOC). Treatments consisted of wound debridements, offloading (if necessary) and appropriate wound dressings. Wound size was measured and amniotic membrane was applied with regard to product protocol. Results were measured against a historical control of wounds treated with SOC only.
RESULTS: Demographic variables that were considered include: body mass index (BMI), hypertension, immune suppressors or steroid use, and the presence of diabetes, cardiac, renal, and vascular diseases. Wound locations treated included: upper extremity (2), back and sacral (8), abdomen (3), ischium (1), thigh (1), and lower extremity (47). All wounds had adequate vascular supply as verified by Doppler ultrasound and all infected wounds were treated with a full course of antibiotics as determined by the infectious diseases specialist. Initially, the wounds measured an average of 43 cm2 (range: 1-441). 15 wounds in 11 patients went on to fully heal. Remaining open wounds had improved and measured an average of 40 cm2 (range: 1-360). Seven patients had negative pressure wound therapy used as an adjunct to assist with the allograft in conforming to the irregular depths of the wounds. All patients with healed wounds regained pre-injury functional status.
CONCLUSION: Human dehydrated amniotic membrane allograft is useful as an adjunct in wound closure techniques in assisting the formation of granulation tissue and healing of complex wounds in all body sites. It can help decrease healing time, and in some cases, eliminate the need for skin grafts or flap reconstruction. It can also help in cases of limb salvage when all other efforts have failed.
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