Use of Dehydrated Amnion /Chorion Membrane (dACM) to Treat Non-Healing Leg Ulcers Caused by Pyoderma Gangrenosum

Background:

• Wounds manifest from multiple etiologies, which result in acute or chronic processes within the integumentary system
• Although “time-to-closure” varies among cases, all wounds must progress through the phases of wound healing to have a successful outcome and wound closure
• Pyoderma gangrenosum is a rare inflammatory condition that causes large, painful ulcers most commonly found on the lower legs
• Amniotic tissues have been widely used to treat chronic wounds, including leg ulcers
• Various formulations of amniotic tissues have shown promise in effectively treating chronic and acute wounds, including dehydrated human amnion chorion membrane (dACM*)
• dACM membranes grafts contain growth cytokines and anti-inflammatory proteins

Objective: The aim of this case series was to evaluate treating difficult-to-heal leg ulcers caused by Pyoderma gangrenosum (PG) using dACM.

Methods:

• Retrospective case series evaluating PG wound outcomes with the use of dACM
• Wounds were cleansed with saline and underwent sharp debridement as necessary
• First application of dACM  was defined as week 0
• dACM was applied weekly using standard technique
• Standard dressings and compression wrapping were used throughout the study
• Patients were seen weekly
• At each clinic visit, wounds were evaluated for size, extent of closure, granulation, and overall appearance
• All images presented were captured after wound cleansing
• All patients gave written approval to include their case in the study

Results and Conclusions:

• The use of dACM appeared to have a positive impact on outcomes in the management of non-healing leg ulcers caused by PG
• All 3 patients included in the case series healed completely
• Randomized, controlled trials in a larger sample of patients are required to validate these preliminary findings