Amniotic Membrane: Can It Have An Impact For DFUs?

Start Page: 36
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Author(s): 
Jennifer Swan, DPM, and Christopher Hyer, DPM, FACFAS

1. Sheehan P, Jones P. A percent change in wound area of diabetic foot ulcers over a 4-week period is a robust predictor of complete wound healing in a 120-week prospective trial. Diabetes Care. 2003;26(6):1879-1882.
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4. Tan EK, Cooke M, et al. Wet vs. dry amniotic membrane tissue grafts: a comparison of cryopreserved and dehydrated tissue processing methods in preserving bioactivity. Tissue Tech Inc. Miami, Fla.
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Dr Leslie aufseesersays: March 4, 2014 at 7:57 pm

I have an end-stage renal patient with poor blood flow, calcified vessels etc. Her wound is over the bunion joint 3 cm x 2.5 cm and channels 2 inches under the first met head. Can I pack the graft into the dead space and use a second graft over the ulcer ?

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H. David Gottlieb, DPMsays: March 31, 2014 at 1:05 pm

Dr. Aufseeser:

I think in your patient's case, you would get better results by using an injectable amniotic implant. This is infiltrated around and under the ulcer, usually in a series of 2 or 3 every other week. In my experience, this promotes vascular neogenesis and then wound healing. It doens't happen overnight but I usually see a dramatic change at week 3 or 4.

The injectables seem to all be similar in action despite what their manufacturers say. My personal favorite seems to be Flograft but I'll use whatever my institution has on hand.

Dave Gottlieb, DPM
Baltimore

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