Wound care accounts for a significant portion of medical spending in the US each year, but amniotic membrane allograft technology may be able to reduce that financial burden by improving wound care practices and patient outcomes.
Amniotic tissue has received considerable attention from the scientific medical community for its ability to improve the healing of a variety of wound types, including surgical, traumatic, pressure wounds, and wounds caused by diabetes or infection.1
Diabetic foot ulcers (DFU) are among the most prevalent and the most likely to become chronic of wound types due to a high incidence of comorbidities including hyperglycemia and neuropathy.2
Amniotic wound care has shown promising results for encouraging chronic wounds such as DFUs to progress through the four known phases of healing: hemostasis, inflammatory, proliferative, and remodeling. Read on to learn more about how human amniotic membrane could revolutionize wound care.
Amniotic membrane lines the inner layer of the placenta, protecting the fetus throughout pregnancy by providing a strong, physical barrier and acting as a filter for metabolites. It regulates the transport of nutrients and water and contains high levels of bioactive molecules that allow it to remain metabolically active to remodel and grow along with the fetus.
The membrane consists of two distinct non-vascular layers. The amnion layer is composed of epithelial cells attached to dense, collagen-based tissue and sits closest to the fetus. The chorion layer is up to five times thicker than the amnion layer and is primarily constructed from collagen and a fibrous matrix.
Among the range of advanced wound care methods, amniotic membranes offer the greatest number of benefits across the widest range of conditions.
Speedy healing times are essential to prevent chronic wound recurrence and minimize the risk of infection.
Amniotic membrane is rich in human growth factors and cytokines which initiate the healing response. It also provides a flexible matrix to allow for the migration and rapid growth of cells, making it the ideal medium to facilitate accelerated epithelialization and reduce wound healing times.
Research suggests that amniotic membranes have an effect on keratinocytes which allows wounds that were previously unable to epithelialize to heal with healthy granular activity. The healing progressed significantly quicker with amniotic membrane involved than when standard wound care treatments were used.
Wound fibrosis results in permanent scar tissue forming to replace the normal, parenchymal tissue, thereby altering the structure and function of tissues and organs. Preventing fibrosis is not only aesthetically important but also vital for preserving the barrier function of the skin.4
An amniotic membrane allograft provides a protective biological barrier to the wound that prevents infection during healing while simultaneously creating an anti-bacterial layer on the wound. Studies have shown that mesenchymal stromal cells found in amniotic membranes inhibit the formation of fibrosis by reducing the production and retention of B cells which, in turn, modulates the activity of T cells to effectively minimize inflammation.
Amniotic membranes have powerful pain-relieving properties. Many researchers believe this is because amniotic membranes reduce inflammation, improve wound bed hydration, and form a protective barrier around exposed nerve endings.
For ophthalmological wound repair, amniotic membranes can prevent friction between the eyelid and eye surface to reduce discomfort. Studies have also shown that patients who had undergone a Caesarian section and had amniotic membranes applied to the wound required fewer analgesics than the control group.
Skin grafts have a high rate of rejection as allogeneic grafting typically initiates a powerful inflammatory response that attacks and destroys donor cells. Unfortunately, most current immunosuppressive therapies used to prevent organ rejection are ineffective for skin grafts. Amniotic allografts reduce the risk of graft rejection and consequent health complications.
Human amniotic membrane is non-immunogenic due to the presence of cytokines and growth factors, so the amniotic membrane allograft will not be seen as a foreign body by the patient’s immune system, reducing the likelihood of rejection. Amniotic membranes also activate anti-inflammatory macrophages and inhibit the production of certain types of T-cells to limit the body’s immune response.
Numerous studies have shown that when compared with other advanced therapies for wound care, such as bioengineered skin substitutes (BSS), amniotic membranes achieve a significantly higher proportion of fully closed wounds within a set time frame. They also require fewer grafts per wound, making them a more cost-effective option than BSS or standard wound care treatments.
Past preparations of amniotic membrane involved sterilization and storage at 4℃ which meant that it was only viable for use up to six weeks. However, new, more efficient ways to preserve amniotic membranes now mean that perinatal tissue products can be dehydrated or cryogenically frozen after sterilization to prolong the shelf-life and make them more easily accessible without affecting performance.5
Cryopreserved amniotic membrane allograft technology has been successfully used for a wide range of wound care treatments including ulcer healing and ophthalmological restoration.
Dehydrated amniotic allograft patches are easy to prepare, apply, and store. They also bond readily with the wound site using hydrostatic tension, forming a stable fibrin-elastin interface.
The improved shelf-life of dehydrated and cryogenically preserved amniotic membranes makes them more accessible than they were previously.
This increase in availability potentially means amniotic membranes may be used more frequently than other advanced wound care modalities, alleviating the financial strain associated with chronic wound care, as fewer grafts are required and membrane grafts are available in multiple sizes.
Managing chronic wounds poses a significant challenge to the medical community. Ineffective treatments not only increase the risk of infection and wound recurrence for patients, but they also put a heavier financial burden on the healthcare system.
Amniotic membrane allografts are a viable solution for enhancing wound care for faster healing times, minimal scarring, and reduced pain. To find out more about how BioStem Technologies perinatal tissue products can assist with wound care in your facility, contact our experienced sales team at (954) 380-8342 or complete our convenient online form.
1. Paggiaro, Andre Oliveira, et al. "Biological effects of amniotic membrane on diabetic foot wounds: a systematic review." Journal of wound care 27.Sup2 (2018): S19-S25.
2. Alavi, Afsaneh, et al. "Diabetic foot ulcers: Part I. Pathophysiology and prevention." Journal of the American Academy of Dermatology 70.1 (2014): 1-e1.
3. Mamede, Ana C., et al. "Amniotic membrane: from structure and functions to clinical applications." Cell and tissue research 349.2 (2012): 447-458.
4. Tao, Huiren, and Hongbin Fan. "Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions." European Spine Journal 18.8 (2009): 1202-1212.
5. Tehrani, Fatemeh A., Abolhassan Ahmadiani, and Hassan Niknejad. "The effects of preservation procedures on antibacterial property of amniotic membrane." Cryobiology 67, no. 3 (2013): 293-298.