Understanding the Impact of Preservation Methods on the Integrity and Functionality of Placental Allografts

Johnson, Amy J. Wagoner; Gyurdieva, Alexandra; Dhall, Sandeep; Danilkovitch, Alla; Duan-Arnold, Yi

doi:10.1097/sap.0000000000001101

Cited by 40 publications

(55 citation statements)

References 54 publications

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“…Placental tissues are processed in various ways, including: cryopreservation, hypothermic storage, and dehydration . Composition and processing alters the proteomic composition and may consequently affect how the grafts function …”

Section: Introductionmentioning

confidence: 99%

Characterisation of dehydrated amnion chorion membranes and evaluation of fibroblast and keratinocyte responses in vitro

McQuilling

Kammer

Kimmerling

et al. 2019

International Wound Journal

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The purpose of this study is to characterise the composition of a dehydrated amnion and chorion graft and investigate how factors released from this graft interact with cells important to the wound microenvironment using in vitro models. Characterisation was completed by proteomic analysis of growth factors and cytokines, evaluation of matrix components and protease inhibition, immunohistochemistry, and in vitro release of key growth factors and cytokines. To evaluate the effect of released factors on cells found within the microenvironment, in vitro assays including: cell proliferation, migration, gene expression, protein production, and intracellular pathway activation were used; additionally, responses of fibroblasts in the context of inflammation were measured. We found that released factors from dehydrated amnion/chorion membranes (dACM) stimulated cell proliferation, migration, and altered gene and protein expression profiles of cells important for wound repair in vitro. When cells were cultured in the presence of pro‐inflammatory cytokines, the addition of releasate from dACM resulted in an altered production of cytokines, including a reduction of pro‐inflammatory regulated on activation, normal T cell expressed and secreted (RANTES). In sum, the results presented here characterise the components of dACM, and in vitro studies were used to evaluate interactions of dACM with cell types important in wound healing.

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Section: Introductionmentioning

confidence: 99%

Characterisation of dehydrated amnion chorion membranes and evaluation of fibroblast and keratinocyte responses in vitro

McQuilling

Kammer

Kimmerling

et al. 2019

International Wound Journal

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“…Previously, a proprietary tissue processing method resulting in viable cryopreserved placental membrane (vCPM) has been reported. This method allows vCPM to retain components and properties of fresh placental tissue . Benefits of vCPM for management of chronic DFUs, including complex wounds with exposed bone or tendon, have been demonstrated in clinical studies .…”

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confidence: 99%

Effectiveness of viable cryopreserved placental membranes for management of diabetic foot ulcers in a real world setting

Raspovic

Wukich

Naiman

et al. 2018

Wound Repair Regeneration

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In a multicenter randomized controlled trial (RCT), the use of viable cryopreserved placental membrane (vCPM) for chronic diabetic foot ulcers (DFUs) resulted in a higher proportion of wound closure in comparison to good wound care: 62% versus 21% (p < 0.01). However, patients in RCTs are not representative of daily physician practice. Healthcare databases serve as a valuable tool to evaluate therapy effectiveness and to supplement evidence from RCTs. The objective of this study was to evaluate the effectiveness of vCPM for DFU management using Net Health's WoundExpert® electronic health records (EHR). The primary endpoint was the proportion of DFUs that achieved complete closure. Other endpoints included time and number of grafts to closure, probability of wound closure by week 12, and the number of wound-related infections and amputations. De-identified EHR data for 360 patients with 441 wounds treated with vCPM were extracted from the database. Average patient age was 63.7 years with a mean wound size of 5.1 cm and an average wound duration of 102 days prior to vCPM treatment. For evaluation of clinical outcomes, 350 DFUs larger than 0.25 cm at baseline were analyzed. Closure at the end of treatment was achieved in 59.4% of wounds with a median treatment duration of 42.0 days and 4 applications of vCPM. The probability of wound closure at week 12 was 71%, and the number of amputations and wound-related infections was 13 (3.0%) and 9 (2.0%), respectively. Data also demonstrated a correlation between wound size and closure rate as well as a correlation between > 50% wound area reduction by week 4 and wound closure by week 12. The results of this study mirror previous RCT efficacy data, supporting the benefits of vCPM for DFU management. These results can also influence policy and treatment decisions regarding advanced vCPM technology.

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“…Human placental membranes (PMs) have a long history in treating burns and wounds 7, 8. The composition of PMs includes three‐dimensional collagen‐rich structural extracellular matrix, growth factors and cytokines, and endogenous tissue viable cells including mesenchymal stem cells 7, 8, 9. PMs have antimicrobial, anti‐inflammatory and antifibrotic properties, all of which are required to support wound healing process 7, 8, 9.…”

Section: Discussionmentioning

confidence: 99%

“…The composition of PMs includes three‐dimensional collagen‐rich structural extracellular matrix, growth factors and cytokines, and endogenous tissue viable cells including mesenchymal stem cells 7, 8, 9. PMs have antimicrobial, anti‐inflammatory and antifibrotic properties, all of which are required to support wound healing process 7, 8, 9. PMs serve as a soft breathable protective barrier that conforms to contoured surfaces of wounds, prevent contamination, and maintain moist wound environment.…”

Section: Discussionmentioning

confidence: 99%

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Understanding the Impact of Preservation Methods on the Integrity and Functionality of Placental Allografts

Cited by 40 publications

References 54 publications

Characterisation of dehydrated amnion chorion membranes and evaluation of fibroblast and keratinocyte responses in vitro

Characterisation of dehydrated amnion chorion membranes and evaluation of fibroblast and keratinocyte responses in vitro

Effectiveness of viable cryopreserved placental membranes for management of diabetic foot ulcers in a real world setting

Nonsurgical management of a large necrotic nasal tip wound using a viable cryopreserved placental membrane

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