• 1.

    Centers for Disease Control and Prevention: National Diabetes Statistics Report, 2014: Estimates of Diabetes and Its Burden in the United States. Atlanta, GA: US Department of Health and Human Services; 2014.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Singh N , Armstrong DG & Lipsky BA: Preventing foot ulcers in patients with diabetes. JAMA 293 : 217, 2005.

  • 3.

    Edwards JL , Vincent AM & Cheng HT et al.: Diabetic neuropathy: mechanisms to management. Pharmacol Ther 120 : 1, 2008.

  • 4.

    Margolis D , Kantor J & Berlin J: Healing of neuropathic ulcers: results of a meta-analysis. Diabetes Care 22 : 692, 1999.

  • 5.

    Moulik P & Gill GV: Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care 26 : 491, 2003.

  • 6.

    Warriner RA , Snyder RJ & Cardinal MH: Differentiating diabetic foot ulcers that are unlikely to heal by 12 weeks following achieving 50% percent area reduction at 4 weeks. Int Wound J 8 : 632, 2011.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Zelen CM , Serena TE & Gould L et al.: Treatment of chronic diabetic lower extremity ulcers with advanced therapies: a prospective, randomised, controlled, multi-centre comparative study examining clinical efficacy and cost. Int Wound J 13 : 272, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Koob TJ , Rennert R & Zabek N et al.: Biological properties of dehydrated human amnion/chorion composite graft: implications for chronic wound healing. Int Wound J 10 : 493, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Koob TJ , Lim JJ & Massee M et al.: Properties of dehydrated human amnion/chorion composite grafts: implications for wound repair and soft tissue regeneration. J Biomed Mater Res B Appl Biomater 102 : 1353, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Niknejad H , Habibollah P & Masoumeh J et al.: Properties of the amniotic membrane for potential use in tissue engineering. Eur Cell Mater 15 : 88, 2008.

  • 11.

    Zelen CM: An evaluation of dehydrated human amniotic membrane allografts in patients with DFUs. J Wound Care 22 : 347, 2013.

  • 12.

    Zelen CM , Serena TE & Denoziere G et al.: A prospective randomised comparative parallel study of amniotic membrane wound graft in the management of diabetic foot ulcers. Int Wound J 10 : 502, 2013.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Zelen CM , Serena TE & Snyder RJ: A prospective, randomised comparative study of weekly versus biweekly application of dehydrated human amnion/chorion membrane allograft in the management of diabetic foot ulcers. Int Wound J 11 : 122, 2014.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Zelen CM , Gould L & Serena TE et al.: A prospective, randomised, controlled, multi-centre comparative effectiveness study of healing using dehydrated human amnion/chorion membrane allograft, bioengineered skin substitute or standard of care for treatment of chronic lower extremity diabetic ulcers. Int Wound J 12 : 724, 2015.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Kirsner RS , Sabolinski ML & Parsons NB et al.: Comparative effectiveness of a bioengineered living cellular construct vs. a dehydrated human amniotic membrane allograft for the treatment of diabetic foot ulcers in a real-world setting. Wound Repair Regen 23 : 737, 2015.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Kraus I , Sabolinski ML & Skornicki M et al.: The comparative effectiveness of a human fibroblast dermal substitute versus a dehydrated human amnion/chorion membrane allograft for the treatment of diabetic foot ulcers in a real-world setting. Wounds 29 : 125, 2017.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17.

    DiDomenico LA , Orgill DP & Galiano RD et al.: Aseptically processed placental membrane improves healing of diabetic foot ulcerations: prospective, randomized clinical trial. Plast Reconstr Surg Glob Open 4 : e1095, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    DiDomenico LA , Orgill DP & Galiano RD et al.: Use of an aseptically processed, dehydrated human amnion and chorion membrane improves likelihood and rate of healing in chronic diabetic foot ulcers: a prospective, randomised, multi-centre clinical trial in 80 patients. Int Wound J 15 : 950, 2018.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Tettelbach W , Cazzell S & Reyzelman AM et al.: 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 16 : 9, 2019.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    Garoufalis M , Nagesh D & Sanchez PJ et al.: Use of dehydrated human amnion/chorion membrane allografts in more than 100 patients with six major types of refractory nonhealing wounds. JAPMA 108 : 84, 2018.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Caporusso J , Abdo R & Karr J et al.: Clinical experience using a dehydrated amnion/chorion membrane construct for the management of wounds. Wounds 31 : S19, 2019.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Glat P , Orgill DP & Galiano R et al.: Placental membrane provides improved healing efficacy and lower cost versus a tissue-engineered human skin in the treatment of diabetic foot ulcerations. Plast Reconstr Surg Glob Open 7 : e2371, 2019.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 23.

    Gruss JS & Jirsch DW: Human amniotic membrane: a versatile wound dressing. Can Med Assoc J 118 : 1237, 1978.

  • 24.

    Vella L & Formosa C: Characteristics predicting the outcome in individuals with diabetic foot ulcerations. JAPMA 107 : 180, 2017.

  • 25.

    Whitney JD: The influence of tissue oxygen and perfusion on wound healing. AACN Clin Issues Crit Care Nurs 1 : 578, 1990.

  • 26.

    Ince P , Kendrick D & Game F et al.: The association between baseline characteristics and the outcome of foot lesions in a UK population with diabetes. Diabet Med 24 : 977, 2007.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 27.

    Shah AP: Using amniotic membrane allografts in the treatment of neuropathic foot ulcers. JAPMA 104 : 198, 2014.

  • 28.

    Mrugala A , Sui A & Plummer M et al.: Amniotic membrane is a potential regenerative option for chronic non-healing wounds: a report of five cases receiving dehydrated human amnion/chorion membrane allograft. Int Wound J 13 : 485, 2016.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 29.

    Penny H , Rifkah M & Weaver A et al.: Dehydrated human amnion/chorion tissue in difficult- to-heal DFUs: a case series. J Wound Care 24 : 104, 2015.

  • 30.

    Hawkins B: The use of micronized dehydrated human amnion/chorion membrane allograft for the treatment of diabetic foot ulcers: a case series. Wounds 28 : 152, 2016.

    • PubMed
    • Search Google Scholar
    • Export Citation

Efficacy of Dehydrated Human Amnion Chorion Membrane in the Treatment of Diabetic Foot Ulcers: A Review

Andrew S. Au
Search for other papers by Andrew S. Au in
Current site
Google Scholar
PubMed
Close
 DPM
,
Wai Y. Leung
Search for other papers by Wai Y. Leung in
Current site
Google Scholar
PubMed
Close
 DPM
, and
James W. Stavosky
Search for other papers by James W. Stavosky in
Current site
Google Scholar
PubMed
Close
 DPM

Studies have been conducted to evaluate the efficacy of dehydrated human amnion chorion membrane (dHACM) in treating recalcitrant diabetic foot ulcers. A literature search was performed to review the data collected from the use of dHACM allografts. Two products were explicitly named in these publications, EpiFix and AmnioBand Membrane. Relevant results included the healing rate, number of wounds healed, and number of grafts used. Data had supported the potential of lowering the overall cost to manage a wound despite a relatively higher cost per dressing. However, discrepancy was observed in the rate of healing between several of the studies. Nonetheless, dHACM had demonstrated improvement in healing of recalcitrant diabetic foot ulcers compared to standard of care alone. These results provide grounds for more inclusive research on dHACM in the future.

California School of Podiatric Medicine, Oakland, CA. Dr. Leung is now with Stony Brook University Hospital, Stony Brook, NY. Dr. Au is now with Yale New Haven Hospital, New Haven, CT.

Daly City Podiatry Group, Daly City, CA.

Corresponding author: Andrew S. Au, DPM, Yale New Haven Hospital, 1450 Chapel St, New Haven, CT 06511. (E-mail: andrew.au@yale.edu)
Save