Chronic Wounds Closure with Amniotic Membrane
Keywords:
wound healing, amniotic membrane, implantsAbstract
Introduction: treating chronic wounds and reducing their healing time is a health problem. The use of the amniotic membrane prevents desiccation, fluid loss and has an analgesic effect.
Objective: to describe the amniotic membrane’s use results as treatment for chronic wounds.
Method: an observational, descriptive, prospective and longitudinal study was carried out in the Plastic Surgery and Caumatology service of the “Hermanos Ameijeiras” Clinical Surgical Hospital in the period between January 2020 and December 2021. The sample was non-probabilistic and for convenience. Quantitative variables were summarized using the mean, standard deviation, median, interquartile range, minimum and maximum values. For the qualitative ones, the distribution was used
Results: the average age was 61.7 ± 8.1 years with a predominance of those over 70 years of age. 73.7% of the patients were male; 31.6% were chronic wounds secondary to trauma and 36.8% occurred in the malleolar region. The median size was 7.5 ± 3.0 cm2 and healing time was 26.5 ± 8.0 days. Postoperative pain and edema improved in 100% of cases. There were no complications and 89.5% of the patients reported being satisfied.
Conclusion: postoperative pain and edema improved after application of the amniotic membrane. There were no complications in the cases studied and the majority reported being satisfied with the procedure.
Keys Words: wound healing; amniotic membrane; implants.
References
1. Calderón W. Historia de la cirugía plástica mundial. W. Calderón, A. Yuri (ed). Cirugía Plástica. Santiago. Sociedad de Cirujanos de Chile 2020; 19-27.
2. Lazaurus GS, Cooper DM, Knigthon DR, Margolis DJ, Pecoraro RE, Rodeheaver G, et al. Definitions and guidelines for assessment of wounds and evaluation of healing. Arch Dermatol [Internet]. 1994;130 (4):489-493. DOI: http://dx.doi.org/10.1001/archderm.1994.01690040093015
3. Domínguez Saavedra G, Hernández Galván JM. Actualización en el manejo de heridas. Cir Plast. 2021;31(3): 124-136. DOI: https://dx.doi.org/10.35366/103715
4. Davis JW. Skin transplantation with a review of 550 cases at Johns Hopkins Hospital. Johns Hopkins Med J [Internet]. 1910 [acceso: 19/12/2019];15:307. Disponible en: https://www.scirp.org/(S(351jmbntvnsjt1aadkposzje))/reference/referencespapers.aspx?referenceid=1040417
5. Fairbain NG, Randolph MA, Redmond RW. The clinical applications of human amnion in plastic surgery. J Plast Reconstr Aesthet Surg [Internet]. 2014; 67 (5):662-75. DOI: http://dx.doi.org/10.1016/j.bjps.2014.01.031
6. Asociación Médica Mundial (AMM). Declaración de Helsinki. Principios éticos para las investigaciones con seres humanos. 59ª Asamblea General, Seúl, Corea, octubre de 2008 [Internet]. [Fecha de consulta: septiembre de 2022]. Disponible en: http://www.wma.net/es/30publications/10policies/b3/index.html
7. Samaniego Ruiz MJ, Palomar Llatas F, Sanmartín Jiménez O. Valoración de las heridas crónicas en el adulto: una revisión integrativa. Rev Esc Enferm USP [Internet]. 2018;52: e03315. DOI: http://dx.doi.org/10.1590/S1980-220X2016050903315
8. Jaimes Contreras Y, Coronado Castro AM. Calidad de vida en personas con heridas crónicas. [Tesis de Grado]. Universidad Cooperativa de Colombia. Bucaramanga, Colombia. 2020 [acceso: 18/09/2022]. Disponible en: http://www.repository.ucc.edu.co/bitstream/20.500.12494/32667/1/2020_JaimesyCoronado-Calidad_Vida_Herida_Cr%25C3%25B3nica.pdf&ved
9. Celis Acevedo EJ. Evaluación de la velocidad de cierre de las úlceras de pie diabético con el uso de derivados acelulares de células madre mesenquimales como tratamiento. [Tesis de Especialidad]. Universidad Autónoma de Bucaramanga. Bucaramanga, Colombia. 2021 [acceso: 18/09/2022]. Disponible en: http://www.repository.unab.edu.co/bitstream/handle/20.500.12749/13931/2021_Tesis_Enmanuel_Jose_Celis-pdf%3Fsequence%3Dy%ved
10. Borys S, Ludwig-Slomczynska AH, Seweryn M, Hohendorff J, Koblik T, Machlowska J, et al. Negative pressure wound therapy in the treatment of diabetic foot ulcers may be mediated through differential gene expression. Acta Diabetol [Internet]. 2019; 56(1): 115-20. DOI: https://doi.org/10.1007/s00592-018-1223-y
11. Salama SE, Eldeeb AE, Elbarbary AH, Abdelghany SE. Adjuvant hyperbaric oxygen therapy enhances healing of nonischemic diabetic foot ulcers compared with standard wound care alone. Int J Lower Extr Wounds [Internet]. 2019; 18:75-80. DOI: https://doi.org/10.1177/1534734619829939
12. Serena TE, Yaakov R, Moore S, Cole W, Coe S, Snyder R. A randomized controlled clinical trial of a hypothermically stored amniotic membrane for use in diabetic foot ulcers. Comp Eff Res [Internet]. 2020;9 (1): 23–30. DOI: https://doi.org/0.2217/cer-2019-0142
13. Vela Anaya G, Stegensek Mejía EM, Leija Hernández C. Características epidemiológicas y costos de la atención de las heridas en unidades médicas de la Secretaría de Salud. Rev Enferm IMSS [Internet]. 2018 [acceso: 18/09/2022]; 26(2): 105-14. Disponible en: http://www.ulceras.mx/documento/caracteristicas-epidemiologicas-y-costos-de-la-atencion-de-las-heridas-en-unidades-medicas-de-la-secretaria-de-salud/&ved
14. Alzate Tangarife LF, Pérez Restrepo V, Restrepo Gómez M. Caracterización de los pacientes atendidos en la clínica de heridas de la clínica CES, en el periodo comprendido entre el 1 de enero del 2018 al 31 de diciembre del 2018. [Tesis de Grado]. Universidad CES. Medellín, Colombia. 2019. [acceso: 18/09/2022]. Disponible en: http://www.repository.ces.edu.co/handle/10946/5160&ved
15. Lentsck MH, Baratieri T, Trincaus MR, Mattei AP, Miyahara CTS. Quality of life related to clinical aspects in people with chronic wound. Rev Esc Enferm USP [Internet]. 2018;52: e03384. DOI: http://dx.doi.org/10.1590/S1980-220X2017004003384
16. Krasner D, Sibbald G. Chronic wound care. 7th ed. San Diego: Appleton and Lange 2022; 12: 120-40.
17. Rodríguez Valiente M. Datos preliminares sobre la epitelización con membrana amniótica en úlceras crónicas de pie diabético. [Tesis de Grado]. Universidad de Murcia. Murcia, España. 2018 [acceso: 18/09/2022]. Disponible en: https://www.dialnet.unirioja.es/servlet/tesis?codigo=258166
18. White R. Hard-to-heal wounds: results of an international survey. Wounds UK [Internet]. 2011 [citado septiembre 2022];7(4):22-31. Disponible en: https://wounds-uk.com/journal-articles/hard-to-heal-wounds-results-of-an-international-survey/
19. Kogan S, Sood A, Granick MS. Amniotic membrane adjuncts and clinical applications in wound healing: A review of the literature. Wounds [Internet]. 2018 [acceso: 18/09/2022];30: 168-173. Disponible en: https://www.hmpgloballearningnetwork.com/site/wounds/article/amniotic-membrane-adjuncts-and-clinical-applications-wound-healing-review-literature
20. Zelen CM, Serena TE, Denoziere G, Fetterolf DE. A prospective randomised comparative parallel study of amniotic membrane wound graft in the management of diabetic foot ulcers. Int Wound J. 2013;10 (5): 502-7. DOI: http://dx.doi.org/10.1111/iwj.12097
21. Thompson P, Hanson DS, Langemo D, Anderson J. Comparing human amniotic allograft and standard wound care when using total contact casting in the treatment of patients with diabetic foot ulcers. Adv Skin Wound Care. 2019; 32 (6): 272-7. DOI: http://dx.doi.org/10.1097/01.ASW.0000557831.78645.85
22. Piamo A, García M, Romero D, Ferrer D. Curación de úlcera venosa crónica de la pierna con aloinjerto de membrana amniocoriónica humana fresca. Biomédica [Internet]. 2022 [acceso: 18/09/2022];42 (1): 17-25. Disponible en: https://www.revistabiomedica.org/index.php/biomedica/article/view/6319
23. Hanumanthappa MB, Gopinathan S, Guruprasad Rai D Amniotic membrane dressing versus conventional dressing in lower limb varicose ulcer: A prospective comparative study. Int J Biol Med Res [Internet]. 2012 [acceso: 18/09/2022]; 3(2): 1616-20. Disponible en: https://www.lides.com.mx/wp-content/uploads/2022/08/Amniotic-Membrane-Dressing-versus-Conventional-Dressing-in-Lower-Limb-Varicose-Ulcer-a-Prospective-Comparative-Study.pdf
24. Osman A, Elbadawy A. A study of amniotic membrane graft in treatment of chronic venous leg ulcers. J Clin Case Rep.2016; 6:1. DOI: http://dx.doi.org/10.4172/2165-7920.1000692
25. Schmiedova I, Dembickaja A, Kiselakova L, Nowakova B, Slama P. Using of amniotic membrane derivatives for the treatment of chronic wounds. Membranes. 2021; 11: 941. DOI: https://doi.org/10.3390/membranes11120941
26. Nanda S, Chakraborty S, Ray A, Inamuddin. Healing of cervical necrotizing fasciitis using amniotic membrane as a dressing material. Natl J Maxillofac Surg. 2011;2(2):147-51. DOI: https://doi.org/10.4103/0975-5950.94469
27. Adly OA, Moghazy AM, Abbas AH, et al. Assessment of amniotic and polyurethane membrane dressings in the treatment of burns. Burns. 2010; 36(5):703-10. DOI: https://doi.org/10.1016/j.burns.2009.09.003
28. Soleimani H, Kazemzadeh J. Shortterm outcomes following amniotic membrane and conventional dressing in skin graft donor site; a randomized clinical trial. Immunopathol Persa. 2022;8(2): e29314. DOI: https://doi.org/10.34172/ipp.2022.29314
29. Mohseni F, Saem J, Sekhavati E, et al. Amniotic membrane for pain control after cesarean section. Crescent J Med Biol Sci [Internet]. 2018 [acceso: 18/09/2022];5(3):198-202. Disponible en: https://www.cjmb.org/uploads/pdf/pdf_CJMB_65.pdf
30. Cooke M, Tan EK, Mandrycky C, He H, O'Connell J, Tseng SC. Comparison of cryopreserved amniotic membrane and umbilical cord tissue with dehydrated amniotic membrane/chorion tissue. J Wound Care [Internet]. 2014;23(10):465-76. DOI: https://doi.org/10.12968/jowc.2014.23.10.465
31. Kia Tan E, Cooke M, Mandrycky C, Mahabole M, He H, O’Connell J, et al. Structural and biological comparison of cryopreserved and fresh amniotic membrane tissues. J Biomater Tissue Eng [Internet]. 2014; 4:1180. DOI: https://doi.org/10.1166/jbt.2014.1180
32. Witherel CE, Yu T, Concannon M, Dampier W, Spiller KL. Immunomodulatory effects of human cryopreserved viable amniotic membrane in a proinflammatory environment in vitro. Cell Mol Bioeng [Internet]. 2017;10(5):451-62. DOI: https://doi.org/10.1007/s12195-017-0494-7
33. Delgado AV, McManus AT and Chambers JP. Exogenous administration of substance P enhances wound healing in a novel skininjury model. Exp Biol Med (Maywood) [Internet]. 2005; 230 (4):271-80. DOI: https://doi.org/10.1177/153537020523000407
34. Piñera Martínez M, Rodríguez Santiesteban O, Del Valle Piñera S. Utilidad de la membrana amniótica en el proceso de cicatrización. MEDISAN [Internet]. 2020 [acceso: 18/09/2022]; 24(4):700-6. Disponible en: http://www.scielo.sld.cu/scielo.php%3Fscript%3Dsci_arttext%26pid%3DS1029-30192020000400700&ved
35. Gaviria Castellanos JL, Gómez Ortega V, Guerrero Serrano L. Manejo de quemaduras faciales de segundo grado con membrana amniótica preservada en glicerol 85%. Cir Plást Iberolatinoam [Internet]. 2018;44(4):401-8. DOI: http://dx.doi.org/10.4321/S0376-78922018000400008
36. Acevedo P. Successful treatment of painful chronic wounds with amniotic and umbilical cord tissue: A case serie. SAGE Open Medical Case Reports [Internet]. 2020; 8: 1-6. DOI: https://doi.org/10.1177/2050313X20910599
37. Monteiro BG, Loureiro RR, Cristovam PC, Covre JL, Gomes JÁP, Kerkis I. Amniotic membrane as a biological scaffold for dental pulp stem cell transplantation in ocular surface reconstruction. Arquivos Brasileiros de Oftalmologia [Internet]. 2019 [acceso: 18/09/2022]; 82(1), 32-7. Disponible en: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-27492019000100032
38. Tettelbach W, Cazzell S, Reyzelman AM, Sigal F, Caporusso JM, Agnew PS. A confirmatory study on the efficacy of dehydrated human amnion/chorion membrane dHACM allograft in the management of diabetic foot ulcers: a prospective, multicentre, randomised, controlled study of 110 patients from 14 wound clinics. Int Wound J [Internet]. 2019;16(1):19-29. DOI: https://doi.org/10.1111/iwj.12976
39. Prakoeswa CRS, Natallya FR, Harnindya D, Thohiroh A, Oktaviyanti RN, Pratiwi KD, et al. The efficacy of topical human amniotic membrane mesenchymal stem cell-conditioned medium (hAMMSC-CM) and a mixture of topical hAMMSCCM + vitamin C and hAMMSC-CM + vitamin E on chronic plantar ulcers in leprosy: A randomized control trial. J Dermatolog Treat [Internet]. 2018;29(8):835-840. DOI: https://doi.org/10.1080/09546634.2018.1467541
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Juan Carlos Muñiz Vigueras, Alicia María Tamayo Carbón, Karel Borroto Martínez, Silvia Vera Shelton
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The authors retain copyright and all unrestricted publication rights.
Medicoquirúrgicas Research is licensed under the Creative Commons Attribution-Noncommercial 4.0 International License (CC BY-NC 4.0) and follows the SciELO Publishing Schema (SciELO PS) for publishing in XML format.
You are free to:
- Share — copy and redistribute the material in any medium or format.
- Adapt — remix, transform, and build upon the material.
The license cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do this in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
Non-Commercial — You may not use the material for commercial purposes.
No Additional Restrictions — You may not apply legal terms or technological measures that legally restrict others from making any use permitted by the license.
Notices:
You do not have to comply with the license for elements of the material in the public domain or where their use is permitted by an applicable exception or limitation.
No warranties are given. The license may not give you all the permissions you need for your intended use. For example, other rights such as publicity, privacy, or moral rights may limit how you use the material.
