Treatment of large, complex, non-healing wounds with cryopreserved amniotic suspension allograft: a case series.
Cryopreserved amniotic suspension allograft (CASA) is a regenerative tissue suspension containing amniotic membrane and amniotic fluid components used for soft-tissue repair, replacement, and reconstruction. The aim of this case series is to examine its effects in different wound types.



In a retrospective series CASA was applied to chronic non-healing wounds. All patients were treated at a single center between June 2013 and December 2014. The criterion for application of CASA was lack of progress toward wound healing despite standard treatments and adjuvant therapies.



We assessed five patients aged between 39 to 86 years old. Three patients had surgical/radiation wounds, one had a sacral pressure ulcer, and one had a diabetic foot ulcer (DFU). All patients experienced progressive improvement in wound area and volume during treatment with CASA. One patient (postmastectomy tissue necrosis) required surgical closure in conjunction with removal of retained sutures. CASA applied topically and subcutaneously was particularly well suited to application in these wounds with large sinus tracts or undermining. All five patients experienced complete wound closure following one to two applications of CASA over 5 to 22 weeks.



This series highlights the effective use of CASA in recalcitrant large soft-tissue wounds, DFUs, and deep wounds with tendon exposure.



This study was supported by a grant from Derma Sciences (Princeton, NJ, US).
North Fulton Hospital Hyperbaric and Wound Care Center, 517 Johnson Ferry Road, NE, Atlanta, GA 30328.
B
B
Marcus
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts / Q000637:transplantation*; D000650:Amnion / Q000637:transplantation*; D015925:Cryopreservation; D017719:Diabetic Foot / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014945:Wound Healing / Q000502:physiology*
advanced wound care; amniotic allograft; diabetic foot ulcer; pressure ulcer; radionecrosis; surgical wound