title: Use of a Dehydrated Amniotic Membrane Allograft on Lower Extremity Ulcers in Patients with Challenging Wounds: A Retrospective Case Series.
abstract: Lower extremity ulcers in patients with diabetes mellitus may take a long time to heal despite the use of advanced topical therapies. A retrospective review of cases was conducted to assess the use of a dehydrated amniotic membrane allograft (DAMA) in a convenience sample of 9 wounds in 8 patients (5 men, 3 women, average age 62 years [range 31-81 years]) with diabetes mellitus and/or vascular disease. Wound data and patient characteristics were abstracted from medical records. Descriptive statistics were used to summarize the data. In 5 of 9 wounds, DAMA was applied after a failure to demonstrate a 50% reduction in area after 4 weeks of treatment with advanced wound care, offloading, and compression as indicated. In 4 wounds, DAMA was applied 2-4 weeks after presentation because of concerns about existing patient risk factors for nonhealing. Wounds were present for an average of 11 weeks (range 1-35 weeks) before application of DAMA. Mean baseline wound area and volume were 3.11 cm2 (± 3.73) and 0.55 cm3 (± 0.58), respectively. All wounds healed in an average of 5.7 (± 2.9) weeks (range: 1-9 weeks) after a mean of 2.7 applications (± 1.7) (range 1-5 applications). No adverse events occurred. These observations suggest prospective, randomized, controlled clinical studies to compare the use of DAMA to other topical treatment modalities are warranted.
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Lintzeris
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Kari
authors.initials: K
authors.lastname: Yarrow
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Laura
authors.initials: L
authors.lastname: Johnson
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Amber
authors.initials: A
authors.lastname: White
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hampton
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Andy
authors.initials: A
authors.lastname: Strickland
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Kristy
authors.initials: K
authors.lastname: Albert
authors.affiliation: Wayne Memorial Wound Healing and Hyperbaric Center, Goldboro, NC.
authors.forename: Arlene
authors.initials: A
authors.lastname: Cook
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts / Q000503:physiopathology*; D001684:Biological Dressings / Q000592:standards / Q000639:trends*; D048909:Diabetes Complications / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D007871:Leg Ulcer / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012189:Retrospective Studies; D014945:Wound Healing