56 - Communication libre
Vascular Access / Vein
3 juin 2021, 17:35 - 19:05, Stream 3: SSCVasculaire & SSCViscérale
Dehydrated human amniotic membrane allograft with spongy layer to improve the outcome of complex non-healing venous ulcers
E. Psathas, M. Menth, B. Egger, D. O. Mayer, Presenter: E. Psathas (Fribourg)
Venous leg ulcers have a significant impact on public health by increased disability, intensive usage of health care resources and high costs. It has been reported that dehydrated human amniotic membrane allografts may kickstart otherwise non-healing wounds through cell-tissue interactions and by the release of growth factors and cytokines in the wound bed [1-3]. We describe our experience on the use of a new dehydrated human amniotic membrane allograft with spongy layer (dHAMA/SL) in a cohort of patients with refractory venous leg ulcers.
All patients with venous leg ulcers that received treatment with a dHAMA/SL in our outpatient wound clinic from January 2018 to July 2020 were identified from the hospital’s database. Inclusion criteria were: (1) Documented reduction of less than 40% of the wound’s surface area within 4 weeks, despite supervised best wound treatment (BWT) by international standards, (2) documented follow-up wound’s surface measurements using a dedicated digital photo planimetry application and (3) more than 2 dHAMA/SL applications. Based on the wound’s surface reduction percentage from baseline (WSRB%) (Fig. 1), wounds were classified as healed (100%), highly (70-99%), moderately (40-70%) or low/non-responding (<40%).
Nineteen patients with 31 wounds satisfying the inclusion criteria were identified during the relevant study period. Patient’s and wound’s baseline characteristics are shown in table 1 and 2. Median wound duration before the start of treatment with dHAMA/SL was 6 months (range 2-360), with 58% of all wounds present more than 6 months. Complete healing was observed in 21 wounds (67.74%), with a median time to complete healing of 77 days (range 29-350). Five wounds (16.13%) showed moderate to high response based on WSRB%, while low or no response was observed in the remaining 5 wounds (16.13%) (Fig. 2). The overall WSRB% at the end of treatment as well as two clinical examples of refractory venous ulcers are shown in Figures 3-5.
Weekly application of dHAMA/SL in patients with long-standing, complex, nonhealing venous ulcers despite BWT led to complete healing or significant improvement in wound healing in the majority (84%) of treated wounds. dHAMA/SL proved to be a safe and useful advanced treatment that should be utilized when treating patients with refractory venous ulcers.