(CS-125) Application of Amniotic Membrane Allografts in Advanced Venous Leg Ulcer: A Case Study and Literature Review

John Shou, PharmD – Baylor College of Medicine; Naomi Lambert, BS – Regenative Labs; Tyler Barrett, NA – Regenative Labs

Introduction: Chronic Venous Insufficiency (CVI) is a lifelong, moribund and debilitating disease process with tremendous personal and financial costs. At its core, CVI involves blood pooling in the lower extremities secondary to inadequate venous blood return, resulting in venous hypertension and incompetence of the one-way valves in the lower extremity veins. As venous circulation slows, metabolic demands of the cells in the lower extremities increase, leading to stasis dermatitis, infection, cellular death, and venous ulceration. This case study aims to report the efficacy of Dehydrated Amniotic Membrane Allograft (DAMA) applications to a chronic right lateral ankle ulcer resulting from chronic venous insufficiency.

Methods: The patient in this study received DAMA applications weekly for six weeks. Upon examination at the initial application, the wound was wet and macerated due to drainage with significant hemosiderosis and lipodermatosclerosis consistent with a Venous Clinical Severity Score (VCSS) of 2.

Results: Upon initial examination on February 1, 2022, the VLU measured 2.00 cm x 1.80 cm (Figure 1). The wound was open and showed clear signs of lipodermatosclerosis. The edges and outline of the ulcer were poorly defined. At the final examination on April 26th, the VLU (Figure 4) was closed.

Discussion: This case study demonstrates that the application of DAMA has the potential to act as an effective barrier to cover and accelerate wound closure time. Future non randomized and randomized controlled trials may further establish standardized protocols for DAMA application in venous ulceration, help create treatment algorithms to predict wound closure endpoints, and encourage innovation that may further accelerate healing time.