title: A Retrospective Case Series of a Dehydrated Amniotic Membrane Allograft for Treatment of Unresolved Diabetic Foot Ulcers.
abstract: BACKGROUND
  Foot ulcers are among the most serious complications of diabetes and can lead to amputation. Diabetic foot ulcers (DFUs) often fail to heal with standard wound care, thereby making new treatments necessary. This case series describes the addition of a dehydrated amniotic membrane allograft (DAMA) to standard care in unresolved DFUs.
  
  
  METHODS
  This is a single-center retrospective chart review of eight patients who had one to three applications of DAMA to nine DFUs that had failed to resolve despite offloading, other standard care, and adjuvant therapies. Following initial DAMA placement, wound size (length, width, depth) was measured every 1 to 2 weeks until closure. The principal outcome assessed was mean time to wound closure; other outcomes included mean percent reduction from baseline in wound area and volume at weeks 2 to 8.
  
  
  RESULTS
  All wounds were closed a mean of 9.2 weeks after the first DAMA application (range, 3.0-13.5 weeks). Compared with baseline, wound area and volume, respectively, were reduced by a mean of 48% and 60% at week 2 and by 89% and 91% at week 8. Time to closure was shorter among four patients who had three DAMA applications (mean, 8.3 weeks; range, 4.0-11.0 weeks) than among three patients who had only one application (mean, 12.1 weeks; range, 9.5-13.5 weeks).
  
  
  CONCLUSIONS
  Chronic, unresolved DFUs treated with DAMA rapidly improved and reached closure in an average of 9.2 weeks. These cases suggest that DAMA can facilitate closure of DFUs that have failed to respond to standard treatments.
authors.forename: Barry I
authors.initials: BI
authors.lastname: Rosenblum
mesh_terms: D000328:Adult; D000368:Aged; D064591:Allografts / Q000637:transplantation*; D000650:Amnion / Q000637:transplantation*; D017719:Diabetic Foot / Q000175:diagnosis* / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012494:Sampling Studies; D012720:Severity of Illness Index; D020858:Tissue and Organ Harvesting; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology*