Placental-Derived Biomaterials and Their Application to Wound Healing: A Review

Abstract

Chronic wounds are associated with considerable patient morbidity and present a significant economic burden to the healthcare system. Often, chronic wounds are in a state of persistent inflammation and unable to progress to the next phase of wound healing. Placental-derived biomaterials are recognized for their biocompatibility, biodegradability, angiogenic, anti-inflammatory, antimicrobial, antifibrotic, immunomodulatory, and immune privileged properties. As such, placental-derived biomaterials have been used in wound management for more than a century. Placental-derived scaffolds are composed of extracellular matrix (ECM) that can mimic the native tissue, creating a reparative environment to promote ECM remodeling, cell migration, proliferation, and differentiation. Reliable evidence exists throughout the literature to support the safety and effectiveness of placental-derived biomaterials in wound healing. However, differences in source (i.e., anatomical regions of the placenta), preservation techniques, decellularization status, design, and clinical application have not been fully evaluated. This review provides an overview of wound healing and placental-derived biomaterials, summarizes the clinical results of placental-derived scaffolds in wound healing, and suggests directions for future work.

Assessing placental membrane treatment efficiency in diabetic foot ulcers: Processing for retention versus lamination

“…This efficiency is likely due to the retention of immunomodulatory, structural and regenerative factors in the processing method of RE-AC. 9,28 From the retrospective data analyzed from three outpatient wound care centers, RE-AC demonstrated a marginally higher expected Percent Area Reduction (xPAR) over 12 weeks, underscoring its effectiveness in managing wound size.…”

“…This comparative analysis of (RE‐AC) and (L‐AC) in treating DFUs highlights the distinct advantages of RE‐AC, especially in terms of application efficiency and wound size reduction. This efficiency is likely due to the retention of immunomodulatory, structural and regenerative factors in the processing method of RE‐AC 9,28 …”

Plasticity of bone marrow-derived cell differentiation depending on microenvironments in the skin

“…Since the 1950s, placenta-derived scaffolds, including the amniotic sac, trophoblast layers, and their combinations, have been used to treat skin injuries. Thus far, numerous placenta-derived biomaterials are available for wound healing, depending on the source (amnion, chorion, trophoblast layers, umbilical cord, or their combination), preservation methods (dehydration or cryopreservation), or cell status (containing viable cells or decellularization) ( Protzman et al, 2023 ). The advantages of placenta-derived scaffolds over human fibroblast-derived scaffolds involve a lower cost [$3846 for placenta-derived scaffolds or $7968 for human fibroblast-derived scaffolds per patient ( Ananian et al, 2018 )] and reliance on their use for treatments over long periods.…”

Human Mesenchymal Stem Cells on Size-Sorted Gelatin Hydrogel Microparticles Show Enhanced In Vitro Wound Healing Activities

“…The duration and quality of wound healing depend on many factors such as local cells or cells migrated to the injury area, growth factors, cytokines, and chemokines, each of which contributes to and regulates the overall wound healing process [7][8][9]. Deviations from the well-orchestrated process lead to delayed wound healing and even chronic wounds or fibrotic diseases [10].…”

“…The devastating effects on patients and alarming costs necessitate the development of more effective wound treatments. In recent years, many new therapeutic strategies have emerged to compliment the standard wound treatment care: TIME (tissue debridement, infection control, moisture balance, and edges of the wound) [10,15]. Among these strategies, cell therapy has gained traction [9,16].…”