Healing of a chronic ulcer of the lower limb of venous origin with fresh human amniochorionic membrane allograft

Alberto Piamo , Mayra García , Dayset Romero , Daisy Ferrer , .

Keywords: Varicose ulcer, allografts, amnion

Abstract

In its fresh state, the amniochorionic membrane contains various multipotential cells, growth factors, and extracellular matrix proteins that contribute to the healing of chronic vascular ulcers. To demonstrate its effectiveness, a fresh human placental membrane allograft was applied to a chronic venous ulcer in the lower limb of an 89-year-old female patient with a 12 x 10 cm ulcerated lesion of 40 years of evolution in the malleolar area of her left lower limb. Sixty days after the graft, the ulcer was healed in 100% of its surface and a light pink scar on the edges indicated possible pigmentation. Fresh human amniochorionic membrane allograft is a therapeutic alternative for the healing of refractory chronic vascular ulcers of the lower extremities.

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References

Nelson EA, Adderley U. Venous leg ulcers. BMJ Clin Evid. 2016;2016:1902.

Stechmiller JK, Lyon D, Schultz G, Gibson DJ, Weaver MT, Wilkie D, et al. Biobehavioral mechanisms associated with nonhealing wounds and psychoneurologic symptoms (pain, cognitive dysfunction, fatigue, depression, and anxiety) in older individuals with chronic venous leg ulcers. Biol Res Nurs. 2019;21:407-19. https://doi.org/10.1177/1099800419853881

Raffetto JD, Ligi D, Maniscalco R, Khalil RA, Mannello F. Why venous leg ulcers have difficulty healing: Overview on pathophysiology, clinical consequences, and treatment. J Clin Med. 2020;10:29. https://doi.org/110.3390/jcm10010029

Sen CK. Human wound and its burden: Updated 2020 Compendium of Estimates. Adv Wound Care. 2021;10:281-92. https://doi.org/10.1089/wound.2021.0026

Leren L, Johansen E, Eide H, Falk RS, Juvet LK, Ljoså TM. Pain in persons with chronic venous leg ulcers: A systematic review and meta-analysis. Int Wound J. 2020;17:466-84. https://doi.org/10.1111/iwj.13296

Probst S, Weller CD, Bobbink P, Saini C, Pugliese M, Buehrer SM, et al. Prevalence and incidence of venous leg ulcers -a protocol for a systematic review. Syst Rev. 2021;10:148. https://doi.org/10.1186/s13643-021-01697-3

Lazarus G, Valle F, Malas M, Qazi U, Maruthur N, Zenilman J, et al. Chronic venous leg ulcer treatment: Future research needs: Identification of future research needs from comparative effectiveness review No. 127. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013.

Steed DL, Attinger C, Colaizzi T, Crossland M, Franz M, Harkless L, et al. Guidelines for the treatment of diabetic ulcers. Wound Repair Regen. 2006;14:680-92. https://doi.org/10.1111/j.1524-475X.2006.00176.x

Hingorani A, LaMuraglia GM, Henke P, Meissner MH, Loretz L, Zinszer KM, et al. The management of diabetic foot: A clinical practice guideline by the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine. J Vasc Surg. 2016;63:3-21. https://doi.org/10.1016/j.jvs.2015.10.003

Rodríguez M. Membrana amniótica en úlceras crónicas de pie diabético. Tesis de Grado. Alicante: Universidad Miguel Hernández; 2017.

Ministerio de Salud de Chile. Departamento Ges y Redes de Alta Complejidad. Norma general técnica para el procuramiento, preservación e implante de tejidos. Santiago de Chile: Ministerio de Salud; 2018.

Koob TJ, Rennert R, Zabek N, Massee M, Lim JJ, Temenoff JS, et al. Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. 2013;10:493-500. https://doi.org/10.1111/iwj.12140

Zare-Bidaki M, Sadrinia S, Erfani S, Afkar E, Ghanbarzade N. Antimicrobial properties of amniotic and chorionic membranes: A comparative study of two human fetal sacs. J Reprod Infertil. 2017;18:218-24.

Schulze U, Hampel U, Sel S, Goecke TW, Thäle V, Garreis F, et al. Fresh and cryopreserved amniotic membrane secrete the trefoil factor family peptide 3 that is well known to promote wound healing. Histochem Cell Biol. 2012;138:243–50. https://doi.org/10.1007/s00418-012-0943-2

McQuilling JP, Kammer M, Kimmerling KA, Mowry KC. Characterisation of dehydrated amnion chorion membranes and evaluation of fibroblast and keratinocyte responses in vitro. Int Wound J. 2019;16:827-40. https://doi.org/10.1111/iwj.13103

Branski LK, Herndon DN, Celis MM, Norbury WB, Masters OE, Jeschke MG. Amnion in the treatment of pediatric partial-thickness facial burns. Burns. 2008;34:393-9. https://doi.org/10.1016/j.burns.2007.06.007

Zelen CM, Serena TE, Gould L, Le L, Carter MJ, Keller J, et al. Treatment of chronic diabetic lower extremity ulcers with advanced therapies: A prospective, randomised, controlled, multicentre comparative study examining clinical efficacy and cost. Int Wound J. 2016;13:272-82. https://doi.org/10.1111/iwj.12566

Kogan S, Sood A, Granick MS. Amniotic membrane adjuncts and clinical applications in wound healing: A review of the literature. Wounds. 2018;30:16873.

DiDomenico LA, Orgill DP, Galiano RD, Serena TE, Carter MJ, Kaufman JP, et al. Aseptically processed placental membrane improves healing of diabetic foot ulcerations: Prospective, randomized clinical trial. Plast Reconstr Surg Glob Open. 2016;4:1095. https://doi.org/10.1097/GOX.0000000000001095

Mermet I, Pottier N, Sainthillier JM, Malugani C, Cairey-Remonnay S, Maddens S, et al. Use of amniotic membrane transplantation in the treatment of venous leg ulcers. Wound Repair Regen. 2007;15:459-64. https://doi.org/10.1111/j.1524-475X.2007.00252.x

Alsina GM, Pedregosa FS. Aplicación de membrana amniótica en el tratamiento de las úlceras crónicas de extremidades inferiores. Actas Dermosifiliogr. 2012;103:608-13. https://doi.org/10.1016/j.ad.2012.01.010

El Heneidy H, Omran E, Halwagy A, Al-Inany H, Al-Ansary M, Gad A. Amniotic membrane can be a valid source for wound healing. Int J Womens Health. 2016;8:225-31. https://doi.org/10.2147/IJWH.S96636

Barbosa M, de Alencar J, Maia A, Cabral D, Barros L, Alencar de Oliveira R, et al. Effects of the application of the amniotic membrane in the healing process of skin wounds in rats. Acta Cir Bras. 2018;33. https://doi.org/10.1590/s0102-865020180020000006

Serena TE, Carter MJ, Le LT, Sabo MJ, DiMarco DT, EpiFix VLU Study Group. A multicenter, randomized, controlled clinical trial evaluating the use of dehydrated human amnion/chorion membrane allografts and multilayer compression therapy vs. multilayer compression therapy alone in the treatment of venous leg ulcers. Wound Repair Regen. 2014;22:688-93. https://doi.org/10.1111/wrr.12227

Serena TE, Yaakov R, DiMarco D, Le L, Taffe E, Donaldson M, et al. Dehydrated human amnion/chorion membrane treatment of venous leg ulcers: Correlation between 4-week and 24-week outcomes. J Wound Care. 2015;24:530-4. https://doi.org/10.12968/jowc.2015.24.11.530

Johnson A, Gyurdieva A, Dhall S, Danilkovitch A, Duan-Arnold Y. Understanding the impact of preservation methods on the integrity and functionality of placental allografts. Ann Plast Surg. 2017;79:203-13. https://doi.org/10.1097/SAP.0000000000001101

McQuilling JP, Vines JB, Kimmerling KA, Mowry KC. Proteomic comparison of amnion and chorion and evaluation of the effects of processing on placental membranes. Wounds. 2017;29:38-42.

Lim LS, Poh RW, Riau AK, Beuerman RW, Tan D, Mehta JS. Propiedades biológicas y ultraestructurales del acelainjerto, una membrana amniótica humana irradiada con γ liofilizada. Arch Oftalmol. 2010;128:1303-10.

Russo A, Bonci P, Bonci P. The effects of different preservation processes on the total protein and growth factor content in a new biological product developed from human amniotic membrane. Cell Tissue Bank. 2012;13:353-61. https://doi.org/10.1007/s10561-011-9261-5

Paolin A, Trojan D, Leonardi A, Mellone S, Volpe A, Orlandi A, et al. Cytokine expression and ultrastructural alterations in fresh-frozen, freeze-dried and γ-irradiated human amniotic membranes. Cell Tissue Bank. 2016;17:399-406. https://doi.org/10.1007/s10561-016-9553-x

Allen CL, Clare G, Stewart EA, Branch MJ, McIntosh OD, Dadhwal M, et al. Augmented dried versus cryopreserved amniotic membrane as an ocular surface dressing. PLoS ONE. 2013;8:e78441. https://doi.org/10.1371/journal.pone.0078441

Therani TF, Firouzeh A, Shabani I, Shabani A. A review on modifications of amniotic membrane for biomedical applications. Front Bioeng Biotechnol. 2021;8:606982. https://doi.org/10.3389/fbioe.2020.606982

How to Cite
1.
Piamo A, García M, Romero D, Ferrer D. Healing of a chronic ulcer of the lower limb of venous origin with fresh human amniochorionic membrane allograft. biomedica [Internet]. 2022 May 1 [cited 2024 May 18];42(Sp. 1):17-25. Available from: https://revistabiomedica.org/index.php/biomedica/article/view/6319

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Published
2022-05-01

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