Wound repair, safety, and functional outcomes in reconstructive lower extremity foot and ankle surgery using a dehydrated amnion/chorion allograft membrane

Abstract

Amniotic membranes are known to be rich in growth factors, cytokines, and matrix proteins, which can help support wound closure and may improve patient outcomes in foot and ankle surgical interventions. In this Institutional Review Board (IRB) approved clinical study, 21 consecutive patients undergoing lower extremity soft tissue and bone reconstruction surgery received dehydrated human amnion and chorion allograft (dHACA) placed as a covering over the deep layers of the surgical wound during closure. Wound healing complications were assessed and American Orthopaedic Foot and Ankle Society (AOFAS) scores were compiled from over a 1-year follow-up period. Summary statistics were calculated for average pain, function, and alignment. The average overall AOFAS pre-treatment score was 35.8 ± 23.0 and the posttreatment score significantly improved to 87.5 ± 6.4 (P = 3.7 Â 10 À10 ). The pain-score improved from pre-treatment at 10.0 ± 11.0 to post-treatment at 36.7 ± 4.8 (P = 5.0 Â 10 À5 ). The pre-treatment function score was 18.7 ± 12.9 and at post-treatment increased to 38.5 ± 5.7 (P = 5.8 Â 10 À5 ). Lastly, the alignment score at pre-treatment was 7.1 ± 4.4 and at post-treatment was 12.4 ± 2.6 (P = .001). These improvements in functional scores were accompanied with clinical observations of reduced surgical complications including a lack of wound dehisance in the cohort. These clinical findings suggest that the application of aseptically processed dHACA may reduce wound complications and as such may aide in clinical improvements in foot and ankle surgical interventions however a larger comparative trial should be considered to validate these initial findings.

potential of amniotic membrane in surgery - current applications

“…Wyniki funkcjonalne pacjentów znacznie poprawiły się, co obserwowano również w wynikach badań klinicznych. Badanie to sugeruje, że stosowanie dHACA w chirurgii stopy może być korzystne dla wspomagania gojenia i zmniejszania powikłań przy jednoczesnym wspomaganiu funkcji pooperacyjnych [16].…”

PURION® processed human amnion chorion membrane allografts retain material and biological properties supportive of soft tissue repair

“…[15][16][17] Additional reports demonstrate that amniotic membranes support wound healing and reduce wound complications, such as surgical site infection, while aiding function post-surgery. 15,18,19 The clinical success of amniotic membrane allografts is related to the processing techniques that preserve the membrane properties, including the biophysical structure and bioactivity, while making them safe and readily accessible for the provider. 9,20 This study looks to evaluate two unique PURION ® processed amniotic tissue allografts to characterize the material properties and the biological activities that are therapeutically relevant to wound healing.…”

“…15–17 Additional reports demonstrate that amniotic membranes support wound healing and reduce wound complications, such as surgical site infection, while aiding function post-surgery. 15,18,19 The clinical success of amniotic membrane allografts is related to the processing techniques that preserve the membrane properties, including the biophysical structure and bioactivity, while making them safe and readily accessible for the provider. 9,20…”

Developing small-diameter vascular grafts with human amniotic membrane: long-term evaluation of transplantation outcomes in a small animal model

“…The human amniotic membrane (AM) is an abundant birth tissue located at the innermost layer of the placenta [21] and a gift of nature, composing a rich amount of structural proteins, growth factors, and cytokines [22][23][24][25]. In the biomedical field, AM has been extensively employed in such operations as ophthalmic, abdominal, dental, plastic surgeries, and wound healing, due to its special features, such as anti-bacterial, anti-inflammatory, anti-scarring, antifibrosis, and low immunogenic properties [26][27][28][29][30]. In our previous studies, we developed a flat patch with the multi-layered decellularized amniotic membrane (DAM) for repairing different types of wounds [31][32][33].…”