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AMNIOTIC MEMBRANE IMPROVES HEALING IN DIABETIC FOOT ULCERS
Autores:
MÓNICA RODRÍGUEZ VALIENTE
,
ANA MARÍA GARCÍA HERNÁNDEZ
,
MIGUEL BLANQUER BLANQUER
, PATRICIO ALCARAZ LORENTE, SONIA ALMANSA SAURA,
MARIA DEL CARMEN ALGUERÓ MARTIN
,
MARIA DOLORES LOPEZ LUCAS
,
FRANCISCO JOSE NICOLAS VILLAESCUSA
,
DARIO SANCHEZ SALINAS
,
FRANCISCA INIESTA MARTINEZ
,
NATALIA GARCÍA INIESTA
, MARTA GALINDO VALERIANO,
DAVID GARCÍA BERNAL
,
MARIA MAR MOLINA MOLINA
,
SANDRA LOPEZ CABALLERO
,
FLORENTINA RAMIRÉZ TOVAR
,
CARMEN GARCÍA DE INSAUSTI
,
GREGORIO CASTELLANOS ESCRIG
,
JOSE MARIA MORALEDA JIMÉNEZ
,
Grupos de investigación:
[GI/IMIB/C061/2011] TRASPLANTE HEMATOPOYÉTICO / TERAPIA CELULAR
Comunicación:
Antecedentes:
The amniotic membrane (AM) is a non-tumorigenic tissue attributed with various biological properties: low immunogenicity, anti-inflammatory, anti-fibrotic and anti-microbial effects. These properties are related to its ability to synthesize and release substances including cytokines and growth factors. AM that is usually discarded after birth, is in our experience, an easily obtained material which processing and management can be easily included in the Criobiology Unit routine with low economic cost. One potential clinical use of AM is as “biologic bandage” for wound healing management in diabetic foot. Foot ulcers are a common complication in patients with diabetes. These ulcers are often slow to heal and can lead to clinical complications as infection, further tissue destruction, osteomyelitis, and amputation and conservative therapies often present disappointing results. We describe results from diabetic patients with neuropathic foot ulcers treated with cryopreserved amniotic membrane allograft.
Métodos:
AM was obtained from healthy mothers who had programmed an elective caesarean operation for obstetric reasons, having revised previously her serological profile, medical history and obtained the written informed consent. Processing of the starting material to obtain the final medicinal product (cryopreserved amniotic applied to eleven patients among 16 and 80 years of age with diabetic foot ulcers under a compassionate use program in the Diabetic Foot Unit of the Universitary Hospital Virgen de la Arrixaca, Murcia. Patients were affected by polyneuropathy, eye disease, diabetic nephropathy and diabetic arteriopathy, with deformations in their feet and previous treatments for periods between 2 months and 4 years. The AM was applied weekly or every ten days until healing or partial or total re-epithelialization of the ulcers.
Resultados:
Median previous treatment duration before AM application was 15 months (range 2-48). Patients received 4 to 40 AM applications of AM at weekly to biweekly intervals (average 11 applications). All patients achieved complete wound closure and median time to closure was 18 weeks (range 3 to 56 weeks). The time evolution of the ulcers was 18 months. A median of 11AM were applied on each lesion for an average treatment period of 56 weeks. Epithelialization 100% was obtained. No adverse events related to its application were observed.
Conclusiones:
The obtained results show that the application of amniotic membrane is a feasible and safe treatment in complex diabetic foot ulcers. More rapid healing may decrease clinical operational costs and prevent long-term medical complications. Furthermore, the treatment achieves re-epithelialization of long evolution injuries that were not achieved with conventional therapies.
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