Management of Chronic Wounds with the Amniotic and Umbilical Cord Tissue Allograft: An Evidenced Based Clinical Perspective

INTRODUCTION:Bi-Layer Amniotic membrane allografts are derived from the Amniotic Sac containing the Amnion & Chorion layers and the Cord membrane Allografts are derived from the Umbilical Cord tissue. These Allografts have been shown to offer safe and effective treatment option for acute & chronic wounds. When applied to wounds, these allograft acts as a soft tissue barrier covering and providing mechanical protection to the wound while delivering a wide variety of cell signaling molecules and growth factors which are vital for wound healing.

METHOD: Amniotic and Umbilical Cord Allografts were applied to (3) different presented clinical cases:< !1) Venous Leg Ulcer Chronic Non-Healing < !2) Pressure Ulcer Right Foot Heel – Stage 4 – Chronic Non-Healing< !3) Surgical Wound – Chronic Non-HealingIn all three presented cases Amniotic & Umbilical Cord Allografts were applied to the wounds and covered with an absorbent pad. Wound dressing was changed once (1) a week. Evaluation was performed on the following basis: Wound Surface area and dept measurements, amount of drainage, and presence of inflammation.

RESULT: The application of Amniotic & Umbilical Cord Allograft in all three presented clinical cases led to 100% wound closure. Collected data suggests that Amniotic & Umbilical Cord Allografts enhances the Proliferation phase of wound healing and minimizes the negative effects of inflammatory cytokines, thus offer an effective treatment option for Chronic wounds.

DISCUSSION: Human amniotic membrane has been used since 1910 to promote granulation tissue in wounds. It has been shown to help in the granulation and re-epithelialization and has bacteriostatic properties. These allografts are dehydrated or cryopreserved and may contain amnion alone or amnion, chorion (bi-layer) and or umbilical cord tissue. Amniotic & Umbilical cord Allografts maintains intrinsic levels of key extracellular matrix in wounds and retains more than 600 signaling proteins, including carbohydrates, growth factors, and cytokines. In addition, these allografts act as a barrier and provides mechanical protection to the tissue injury site.