The use of amelogenin protein in the treatment of hard-to-heal wounds

Abstract

The management of hard-to-heal or chronic wounds places a high economic burden on healthcare services. This problem is exacerbated by the increasing age of the general population, an increasing diabetes population and a high prevalence of such wounds in the elderly, patients with diabetes and those with venous insufficiency. Standard treatments for such wounds, such as compression therapy in venous leg ulcers, debridement and wound care for diabetic foot ulcers, can still leave a significant population with non-healing wounds, resulting in extended hospital stays and reduced quality of life. The use of amelogenin (Xelma, Mölnlycke Health Care) for the treatment of a variety of chronic wounds has been assessed in both case studies and larger clinical trials with encouraging findings. This article examines the findings of studies relating to amelogenin in the treatment of hard-to-heal wounds.

Subepithelial connective tissue graft with or without enamel matrix derivative for the treatment of multiple Class III‐IV recessions in lower anterior teeth: A 3‐year randomized clinical trial

“…27 Indeed, EMD sold under the trademark Xelma showed the potential therapeutic uses of this protein for the treatment of "hard to heal" ulcers such as diabetic foot ulcers and rheumatoid disease. 28,29 The result of the present study is also consistent with a study performed by Cortellini et al (2007), whereby the use of EMD for periodontal regeneration resulted in good clinical outcomes while reducing patient morbidity in the first 2 weeks postregenerative therapy. 10 The results of the present study support the use of EMD as an adjunct to CTG in the management of more severe gingival REC (Millers Type III-IV) on lower anterior teeth, as it was able to achieve a more stable GM and increase the amount of KT in the long term, and reduce patient-reported postoperative pain in the short term.…”

A 3‐year prospective clinical and patient‐centered trial on subepithelial connective tissue graft with or without enamel matrix derivative in Class I‐II Miller recessions

“…EMD has been shown to play a significant role in wound healing favoring soft tissue regeneration and angiogenic activity . Indeed, EMD sold under the trademark Xelma ® showed the potential therapeutic uses of this protein for the treatment of “hard to heal” ulcers such as diabetic foot ulcers and rheumatoid disease . With regard to patient satisfaction with the provided treatment, although the results did not reach statistical significance, there was a trend toward more patients in group 1 answering “Yes” to the question “Will you have the treatment again?” (85.7% in test group) when compared to group 2 (73.6%).…”

The role of oxygen‐associated therapies for the healing of chronic wounds, particularly in patients with diabetes

“…In acute wounds, healing takes place immediately and progresses smoothly through defined phases, allowing maximal tensile strength of the tissue structure to be fully achieved by week twelve 7 . A chronic wound or ulcer is an area that presents difficulty in healing, and fails to proceed through normal wound healing phases 8,9 . All wounds have the potential of becoming chronic if there are underlying systemic disorders, nutritional deficiencies or vascular compromise, resulting in inadequate or interrupted blood supply to an area, and therefore a hypoxic tissue state 7 …”

“…7 A chronic wound or ulcer is an area that presents difficulty in healing, and fails to proceed through normal wound healing phases. 8,9 All wounds have the potential of becoming chronic if there are underlying systemic disorders, nutritional deficiencies or vascular compromise, resulting in inadequate or interrupted blood supply to an area, and therefore a hypoxic tissue state. 7 Chronic wounds are considered to be a clinical concern within the National Health Service, causing a major health care burden 10,11 and, recently, it was conservatively estimated that £2.3-3.1 billion was spent on treatment in this area.…”