Amnion Membrane in Diabetic Foot Wounds: A Meta-analysis

Overview

Journal Plast Reconstr Surg Glob Open

Specialty General Surgery

Date 2017 May 17

PMID 28507863

Citations 15

Authors

Alexandra M Haugh

Jacqueline G Witt

Adam Hauch

Michael Darden

Geoffrey Parker

Warren A Ellsworth

Joseph F Buell

Affiliations

Soon will be listed here.

Abstract

Background: Amniotic membrane is tissue obtained from human placenta rich in cytokines, growth factors, and stem cells that possess the ability to inhibit infection, improve healing, and stimulate regeneration.

Methods: A meta-analysis was performed examining randomized controlled trials comparing amniotic tissue products with standard of care in nonhealing diabetic foot ulcers including PubMed, Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews.

Results: A search of 3 databases identified 596 potentially relevant articles. Application of selection criteria led to the selection of 5 randomized controlled trials. The 5 selected randomized controlled trials represented a total of 311 patients. The pooled relative risk of healing with amniotic products compared with control was 2.7496 (2.05725-3.66524, < 0.001).

Conclusions: The current meta-analysis indicates that the treatment of diabetic foot ulcers with amniotic membrane improves healing rates in diabetic foot ulcers. Further studies are needed to determine whether these products also decrease the incidence of subsequent complications, such as amputation or death, in diabetic patients.

Citing Articles

The Collection and Application of Autologous Amniotic Fluid to Cesarean Delivery Closure.

Grotegut C, Weaver K, Fried L, Dotters-Katz S, Gilner J AJP Rep. 2025; 14(4):e262-e269.

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A Biologic and Physical Characterization of an Injectable Amniotic Membrane Designed for Treating Diabetic Foot Ulcers.

Velarde K, Arvonen A, Gonzalez T, Diller R Bioengineering (Basel). 2024; 11(11).

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An forming gelatin-based hydrogel loaded with soluble amniotic membrane promotes full-thickness wound regeneration in rats.

Azimi-Alamouty M, Habibi M, Sadrabadi A, Jamalpoor Z Iran J Basic Med Sci. 2024; 27(8):1005-1014.

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Bioengineering Skin Substitutes for Wound Management-Perspectives and Challenges.

Kondej K, Zawrzykraj M, Czerwiec K, Deptula M, Tyminska A, Pikula M Int J Mol Sci. 2024; 25(7).

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Cost effectiveness analysis for commonly used human cell and tissue products in the management of diabetic foot ulcers.

Nherera L, Banerjee J Health Sci Rep. 2024; 7(3):e1991.

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References

Branski L, Herndon D, Celis M, Norbury W, Masters O, Jeschke M . Amnion in the treatment of pediatric partial-thickness facial burns. Burns. 2007; 34(3):393-9. DOI: 10.1016/j.burns.2007.06.007. View

Adly O, Moghazy A, Abbas A, Ellabban A, Ali O, Mohamed B . Assessment of amniotic and polyurethane membrane dressings in the treatment of burns. Burns. 2009; 36(5):703-10. DOI: 10.1016/j.burns.2009.09.003. View

Sheikh E, Sheikh E, Fetterolf D . Use of dehydrated human amniotic membrane allografts to promote healing in patients with refractory non healing wounds. Int Wound J. 2013; 11(6):711-7. PMC: 7950830. DOI: 10.1111/iwj.12035. View

Salehi S, Asadi K, Mousavi S, Shoar S . Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients. Indian J Surg. 2016; 77(Suppl 2):427-31. PMC: 4692919. DOI: 10.1007/s12262-013-0864-x. View

Mohammadi A, Ghoddusi Johari H, Eskandari S . Effect of amniotic membrane on graft take in extremity burns. Burns. 2013; 39(6):1137-41. DOI: 10.1016/j.burns.2013.01.017. View

Bujang-Safawi E, Halim A, Khoo T, Dorai A . Dried irradiated human amniotic membrane as a biological dressing for facial burns--a 7-year case series. Burns. 2010; 36(6):876-82. DOI: 10.1016/j.burns.2009.07.001. View

John T . Human amniotic membrane transplantation: past, present, and future. Ophthalmol Clin North Am. 2003; 16(1):43-65, vi. DOI: 10.1016/s0896-1549(02)00110-4. View

Rice J, Desai U, Cummings A, Birnbaum H, Skornicki M, Parsons N . Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2013; 37(3):651-8. DOI: 10.2337/dc13-2176. View

Fetterolf D, Snyder R . Scientific and clinical support for the use of dehydrated amniotic membrane in wound management. Wounds. 2015; 24(10):299-307. View

10.

Akle C, Adinolfi M, Welsh K, Leibowitz S, McColl I . Immunogenicity of human amniotic epithelial cells after transplantation into volunteers. Lancet. 1981; 2(8254):1003-5. DOI: 10.1016/s0140-6736(81)91212-5. View

11.

Lavery L, Fulmer J, Shebetka K, Regulski M, Vayser D, Fried D . The efficacy and safety of Grafix(®) for the treatment of chronic diabetic foot ulcers: results of a multi-centre, controlled, randomised, blinded, clinical trial. Int Wound J. 2014; 11(5):554-60. PMC: 7951030. DOI: 10.1111/iwj.12329. View

12.

Eskandarlou M, Azimi M, Rabiee S, Seif Rabiee M . The Healing Effect of Amniotic Membrane in Burn Patients. World J Plast Surg. 2016; 5(1):39-44. PMC: 4904137. View

13.

Gregg E, Sorlie P, Paulose-Ram R, Gu Q, Eberhardt M, Wolz M . Prevalence of lower-extremity disease in the US adult population >=40 years of age with and without diabetes: 1999-2000 national health and nutrition examination survey. Diabetes Care. 2004; 27(7):1591-7. DOI: 10.2337/diacare.27.7.1591. View

14.

Mostaque A, Rahman K . Comparisons of the effects of biological membrane (amnion) and silver sulfadiazine in the management of burn wounds in children. J Burn Care Res. 2011; 32(2):200-9. DOI: 10.1097/BCR.0b013e31820aad94. View

15.

Koob T, Lim J, Massee M, Zabek N, Denoziere G . Properties of dehydrated human amnion/chorion composite grafts: Implications for wound repair and soft tissue regeneration. J Biomed Mater Res B Appl Biomater. 2014; 102(6):1353-62. DOI: 10.1002/jbm.b.33141. View

16.

Mermet I, Pottier N, Sainthillier J, Malugani C, Cairey-Remonnay S, Maddens S . Use of amniotic membrane transplantation in the treatment of venous leg ulcers. Wound Repair Regen. 2007; 15(4):459-64. DOI: 10.1111/j.1524-475X.2007.00252.x. View

17.

Koob T, Rennert R, Zabek N, Massee M, Lim J, Temenoff J . Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J. 2013; 10(5):493-500. PMC: 4228928. DOI: 10.1111/iwj.12140. View

18.

Hicks C, Selvarajah S, Mathioudakis N, Sherman R, Hines K, Black 3rd J . Burden of Infected Diabetic Foot Ulcers on Hospital Admissions and Costs. Ann Vasc Surg. 2016; 33:149-58. PMC: 6048950. DOI: 10.1016/j.avsg.2015.11.025. View

19.

Subrahmanyam M . Amniotic membrane as a cover for microskin grafts. Br J Plast Surg. 1995; 48(7):477-8. DOI: 10.1016/0007-1226(95)90123-x. View

20.

Forbes J, Fetterolf D . Dehydrated amniotic membrane allografts for the treatment of chronic wounds: a case series. J Wound Care. 2012; 21(6):290, 292, 294-6. DOI: 10.12968/jowc.2012.21.6.290. View