Amniotic membrane is a potential regenerative option for chronic non‐healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft

Abstract

Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft. Int Wound J 2016; 13:485-492 Abstract A case series of five patients with a total of six chronic non-healing wounds (>30 day duration) were non-randomly selected to evaluate the performance, safety and handling properties of dehydrated human amnion/chorion membrane allograft, an amniotic membrane scaffolding product. The patients had lower extremity wounds that had previously failed standard of care within a university outpatient/inpatient wound healing programme. Five wounds treated with dehydrated amnion/chorion membrane allograft showed a mean 43% area reduction from baseline (51% median) at 3 weeks into treatment and completely healed with a 64-day median time to closure (SD ±27⋅6 days). One wound worsened at 3 weeks and was found to have a complete central vein obstruction that was treated with long-term mild compression but still eventually healed at 6 months. Removing this outlier, the four responding wounds had a 72% mean and 69% median change in area from baseline, at the 3 week point. All five patients received only one application of dehydrated human amnion/chorion membrane allograft, and there were no adverse events. The product was easy to use, administer and handle. In summary, dehydrated human amnion/chorion membrane allograft appears to be a safe, effective and easy to use therapy for chronic non-healing wounds. This study describes the details of these clinical cases and provides an overview of the current evidence on the use of amniotic tissue in clinical practice.

Effects of acellular equine amniotic allografts on the healing of experimentally induced full‐thickness distal limb wounds in horses

“…It has been shown in vitro that fibroblasts and keratinocytes remain viable and proliferate when attached to decellularized amniotic scaffolds, similarly to the StemWrap tested in this study . Several human clinical trials and case series have also used decellularized and, often, dehydrated amniotic membrane products with associated growth factors to treat chronic nonhealing wounds, including diabetic foot ulcers and venous leg ulcers . In these studies, production of granulation tissue was not assessed or quantitated, but decreased time to healing was reported with these products as well as resolution of wounds that had previously failed with standard‐of‐care treatment.…”

“…in vivo studies in man have substantiated these in vitro findings that these products improve the rate of wound healing . Furthermore, several case series have documented the use of decellularized amniotic membrane scaffolds facilitating the healing of pharyngocutaneous fistulas, burns, bed sores, and chronic wounds that were nonresponsive to standard‐of‐care treatments in human patients . Human amniotic membrane products have been commercially available and used clinically over the past decade in human medicine .…”

“…They have consequently been investigated as a biological source for scaffolds . Amniotic scaffolds have been produced after extensive processing and decellularization techniques to address concerns regarding transmissible diseases in human medicine . Amniotic scaffolds can also be dehydrated, thereby allowing sterilization with gamma irradiation .…”

“…[19][20][21][22] Amniotic scaffolds have been produced after extensive processing and decellularization techniques to address concerns regarding transmissible diseases in human medicine. [22][23][24][25] Amniotic scaffolds can also be dehydrated, thereby allowing sterilization with gamma irradiation. 22,26,27 Such process improves safety, facilitates storage at room temperature, and allows use in a point-of-care clinical setting.…”

A Cost-Effective Method to Assemble Biomimetic 3D Cell Culture Platforms

“…It has been used as a surgical graft for decades. Although the use of hAM, for the most part, has focused on ocular applications[24, 25], other uses emerged to expand its applicability as a graft for treating chronic wounds [26] or as a substrate for culturing neural cells[27]. These applications rely on the widely acknowledged properties of the hAM in enhancing proliferation of cells of ectodermal origin.…”