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Miranda EP, Friedman A. Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema. Eplasty. 2016;16:e26
Miranda, E. P., & Friedman, A. (2016). Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema. Eplasty, 16e26.
Miranda, Edward P, and Friedman, Alex. "Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema." Eplasty vol. 16 (2016): e26.
Miranda EP, Friedman A. Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema. Eplasty. 2016 Sep 07;16:e26. eCollection 2016. PMID: 27648116; PMCID: PMC5016387.
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Eplasty. 2016 Sep 07;16:e26. eCollection 2016.

Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema.

Eplasty

Edward P Miranda, Alex Friedman

Affiliations

  1. Center for Complex Reconstruction, San Francisco, Calif; Department of Plastic Surgery, California Pacific Medical Center, San Francisco.
  2. Center for Complex Reconstruction, San Francisco, Calif.

PMID: 27648116 PMCID: PMC5016387

Abstract

OBJECTIVE: Ulceration of free flaps in patients with venous insufficiency and/or lymphedema is an uncommon but challenging problem. We hypothesized that dehydrated human amnion/chorion membrane (Epifix) grafts would accelerate healing of these challenging ulcers.

METHODS: Retrospective analysis of prospectively acquired data identified 8 lower extremity free flaps with ulcerations in the context of venous insufficiency and/or lymphedema. The first 4 were flaps that had been treated with conservative wound care to healing. The second group was treated conservatively initially but then converted to treatment with dehydrated human amnion/chorion membrane grafts. The primary endpoint was time to healing.

RESULTS: Comparison of Kaplan-Meier survival curves revealed a significant difference between the conservatively and dehydrated human amnion/chorion membrane-treated flap ulcers, favoring graft treatment (P = .0361). In those ulcers that healed, the average time to healing was 87 days for the conservative treatment group and 33 days for the dehydrated human amnion/chorion membrane treatment group (with an average of 1.7 grafts per ulcer).

CONCLUSIONS: Dehydrated human amnion/chorion membrane may accelerate healing of ulcers on lower extremity free flaps in patient with lymphedema and/or venous disease in the treated leg.

Keywords: amnion/chorion; free flap; lymphedema; microsurgery; venous ulcer

References

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