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. 2016 Jun 27:8:225-31.
doi: 10.2147/IJWH.S96636. eCollection 2016.

Amniotic membrane can be a valid source for wound healing

Hossam ElHeneidy  1 , Eman Omran  1 , Ahmed Halwagy  1 , Hesham Al-Inany  1 , Mirvat Al-Ansary  2 , Amr Gad  3
Affiliations

Amniotic membrane can be a valid source for wound healing

Hossam ElHeneidy et al. Int J Womens Health. .

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.

Subjects and 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.

Conclusion: AM graft can be of value in wound healing. Further studies are needed to confirm these findings.

Keywords: amniotic membrane; cesarean section; placenta; ulcer.

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Figures

Figure 1
Figure 1
Preparation of amniotic membrane pieces.
Figure 2
Figure 2
Amniotic membrane application over two leg ulcers. Notes: Two leg ulcers in one patient (A); application of amniotic membrane over the leg ulcers (B and C); image of the patient after amniotic membrane grafting (D).
Figure 3
Figure 3
Vaseline dressing is added over amniotic membrane and then covered with dressing. Notes: Application of vaseline dressing (A and B); application of gauze dressing after vaseline (C); gauze wrapping at the end (D).
Figure 4
Figure 4
Healing of two leg ulcers after amniotic membrane application. Notes: Two leg ulcers in one patient (A); application of amniotic membrane on the two ulcers (B); reduction in size of both ulcers (C); complete healing of the upper ulcer and 70% reduction in the size of the lower one on follow up (D).
See this image and copyright information in PMC

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