Garoufalis M, Nagesh D, Sanchez PJ, Lenz R, Park SJ, Ruff JG, Tien A, Goldsmith J, Seat A, et al.
Journal of the American Podiatric Medical Association. Date of publication 2018 Mar 1;volume 108(2):84-89.
1. J Am Podiatr Med Assoc. 2018 Mar;108(2):84-89. doi: 10.7547/17-039.
Use of Dehydrated Human Amnion/Chorion Membrane Allografts in More Than 100
Patients with Six Major Types of Refractory Nonhealing Wounds.
Garoufalis M, Nagesh D, Sanchez PJ, Lenz R, Park SJ, Ruff JG, Tien A, Goldsmith
J, Seat A.
BACKGROUND: Biochemical properties of the amniotic membrane help modulate
inflammation and enhance soft-tissue healing. In controlled trials, the efficacy
of dehydrated human amnion/chorion membrane (dHACM) allografts has been
established. Our purpose is to describe our experience with using dHACM to treat
nonhealing wounds of various etiologies.
METHODS: We conducted a retrospective review of deidentified data from 117
consecutive patients treated in an outpatient clinic with dHACM allografts with
wounds of various etiologies over 2 years. The decision to use advanced
wound-care treatments is based on rate of healing observed after initiation of
standard wound care and patient risk factors. Eligibility for treatments such as
amniotic membrane allografts includes wounds without 50% reduction after 4
weeks, or earlier in patients deemed to be at high risk for nonhealing or with a
history of chronic wounds. In micronized or sheet formulation, dHACM is applied
to the wound weekly after sharp/mechanical debridement as necessary, and
wound-care practices appropriate for wound type and location are continued.
RESULTS: Thirty-four percent of allograft recipients had diabetic foot ulcers,
25% had venous leg ulcers, 20% had surgical wounds, 14% had pressure ulcers, 6%
had ischemic wounds, and 2% had traumatic wounds. Complete healing occurred in
91.1% of treated patients, with a mean ± SD number of weekly applications per
healed wound of 5.1 ± 4.2.
CONCLUSIONS: In addition to wounds of diabetic origin, dHACM can significantly
expedite healing in refractory wounds of varying etiologies.
DOI: 10.7547/17-039
PMID: 29634297 [Indexed for MEDLINE]
