title: Amniotic membrane can be a valid source for wound healing.
abstract: Amniotic membrane (AM) can promote proper epithelialization with suppression of excessive fibrosis by creating a supportive milieu for regeneration of chronic ulcer bed.
  
  
  OBJECTIVE
  The objective of this study is to investigate whether AM scaffold can modulate the healing of a wound by promoting tissue reconstruction rather than promoting scar tissue formation.
  
  
  METHODS
  AM was obtained and prepared and then applied to patients with chronic leg ulcers who were randomly divided into two different groups. Group I (control group) included eleven patients in whom ulcers were treated with conventional wound dressings that were changed daily for 8 weeks. Group II (study group) included 14 patients in whom the AM was placed in contact with the ulcer and held in place with a secondary dressing, which was changed daily. Follow-up was done to detect healing rate and detection of ulcer size, assessment of pain, and to take ulcer images (days 0, 7, 14, 21, 30, 45, and 60).
  
  
  RESULTS
  In group I, all ulcers showed no reduction in their size, and ulcer floor remained the same. Healthy granulations were present in two ulcers (18.2%) and absent in nine ulcers (81.8%). There was no improvement of pain level in the eleven ulcers. In group II, complete healing of 14 ulcers occurred in 14-60 days with a mean of 33.3±14.7; healing rate range was 0.064-2.22 and the mean 0.896±0.646 cm(2)/day. Healthy granulations were present in 13 ulcers (92.9%) and absent in one ulcer (7.1%). Three ulcers (21.4%) were of mild severity (grade 1 ulcers) while eleven ulcers (78.6%) were of moderate severity (grade 2 ulcers). The healing rate was faster in ulcers of mild severity (1.7±0.438 cm(2)/day) in comparison to ulcers of moderate severity (0.673±0.498 cm(2)/day). Eleven cases (78.6%) showed improvement in their pain level on a scale from 0 to 10.
  
  
  CONCLUSIONS
  AM graft can be of value in wound healing. Further studies are needed to confirm these findings.
authors.affiliation: Department of Obstetrics & Gynecology.
authors.forename: Hossam
authors.initials: H
authors.lastname: ElHeneidy
authors.affiliation: Department of Obstetrics & Gynecology.
authors.forename: Eman
authors.initials: E
authors.lastname: Omran
authors.affiliation: Department of Obstetrics & Gynecology.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Halwagy
authors.affiliation: Department of Obstetrics & Gynecology.
authors.forename: Hesham
authors.initials: H
authors.lastname: Al-Inany
authors.affiliation: Department of Clinical Pathology.
authors.forename: Mirvat
authors.initials: M
authors.lastname: Al-Ansary
authors.affiliation: Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Amr
authors.initials: A
authors.lastname: Gad
keywords: amniotic membrane; cesarean section; placenta; ulcer