Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Feb 4;6(3):38-45.
doi: 10.1016/j.jccw.2016.01.002. eCollection 2014 Dec.

Dehydrated Amniotic Membrane Allograft for Treatment of Chronic Leg Ulcers in Patients With Multiple Comorbidities: A Case Series

Stephen M Barr  1
Affiliations

Dehydrated Amniotic Membrane Allograft for Treatment of Chronic Leg Ulcers in Patients With Multiple Comorbidities: A Case Series

Stephen M Barr. J Am Coll Clin Wound Spec. .

Abstract

Cellular and/or tissue-based products (CTPs) are emerging treatment options for chronic non-healing wounds. Dehydrated amniotic membrane allograft (DAMA) was used in 7 patients whose wounds had not responded adequately to standard and adjuvant therapies; four VLUs, 2 surgical wounds, and 1 DFU. Patients had multiple comorbidities, including 2 with autoimmune disorders (CREST syndrome and systemic lupus erythematosus). Patients received 3-8 applications of DAMA at weekly to biweekly intervals (average, 5.4 applications). Complete wound healing was observed in 6 of 7 patients during study period, with an average time to closure of 7.9 weeks. Closure was achieved in 3 of 7 patients after 3 DAMA applications. In the patient with CREST syndrome who did not completely close, DAMA reduced the area and volume by nearly 50% and later went on to closure. These cases suggest that DAMA is a viable option for recalcitrant DFUs, VLUs, and surgical wounds.

Keywords: Allograft; Amniotic membrane; Biologic tissue-based products; Leg ulcer; Wound healing.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A 97-year-old female with a right anterior lower leg venous leg ulcer (Patient 1). (A) Prior to first dehydrated amniotic membrane allograft (DAMA) application. (B) 2 weeks after first DAMA application. (C) 4 weeks after first DAMA application. (D) 7 weeks after first DAMA application (closure).
Figure 2
Figure 2
A 56-year-old male with a left medial lower leg venous leg ulcer (Patient 2). (A) Prior to first dehydrated amniotic membrane allograft (DAMA) application. (B) 2 weeks after first DAMA application. (C) 4 weeks after first DAMA application. (D) 15 weeks after first DAMA application (closure).
Figure 3
Figure 3
A 57-year-old female with a right lateral ankle surgical wound over the distal fibula (Patient 3). (A) Prior to first dehydrated amniotic membrane allograft (DAMA) application. (B) 4 weeks after first DAMA application. (C) 6 weeks after first DAMA application. (D) 8 weeks after first DAMA application.
Figure 4
Figure 4
A 56-year-old female with an anterior right knee surgical wound (Patient 4). (A) Prior to first dehydrated amniotic membrane allograft (DAMA) application. (B) 4 weeks after first DAMA application (closure).
See this image and copyright information in PMC

References

    1. Graham I.D., Harrison M.B., Nelson E.A., Lorimer K., Fisher A. Prevalence of lower-limb ulceration: a systematic review of prevalence studies. Adv Skin Wound Care. 2003;16:305–316. - PubMed
    1. Callam M.J., Harper D.R., Dale J.J., Ruckley C.V. Chronic ulcer of the leg: clinical history. Br Med J (Clin Res Ed) 1987;294:1389–1391. - PMC - PubMed
    1. Jockenhofer F., Gollnick H., Herberger K. Aetiology, comorbidities and cofactors of chronic leg ulcers: retrospective evaluation of 1000 patients from 10 specialised dermatological wound care centers in Germany. Int Wound J. 2014 - PMC - PubMed
    1. Hostetler S.G., Xiang H., Gupta S., Sen C., Gordillo G.M. Discharge patterns of injury-related hospitalizations with an acute wound in the United States. Wounds. 2006;18:340–351.
    1. Alexiadou K., Doupis J. Management of diabetic foot ulcers. Diabetes Ther. 2012;3:4. - PMC - PubMed