LymphedemaV1, Main, Exploration, bibRecord, 001217

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

Identifieur interne : 001217 ( Main/Exploration ); précédent : 001216; suivant : 001218

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

Auteurs : Edward P. Miranda [États-Unis] ; Alex Friedman

Source :

Eplasty [ 1937-5719 ] ; 2016.

RBID : PMC:5016387

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.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5016387

PubMed: 27648116
PubMed Central: 5016387

Affiliations:

Le document en format XML

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<affiliation wicri:level="3"><nlm:aff id="aff2">Department of Plastic Surgery, California Pacific Medical Center, San Francisco</nlm:aff>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema</title>
<author><name sortKey="Miranda, Edward P" sort="Miranda, Edward P" uniqKey="Miranda E" first="Edward P." last="Miranda">Edward P. Miranda</name>
<affiliation><nlm:aff id="aff1">Center for Complex Reconstruction, San Francisco, Calif</nlm:aff>
<wicri:noCountry code="subfield">Calif</wicri:noCountry>
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<affiliation wicri:level="3"><nlm:aff id="aff2">Department of Plastic Surgery, California Pacific Medical Center, San Francisco</nlm:aff>
<country>États-Unis</country>
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<region type="state">Californie</region>
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<author><name sortKey="Friedman, Alex" sort="Friedman, Alex" uniqKey="Friedman A" first="Alex" last="Friedman">Alex Friedman</name>
<affiliation><nlm:aff id="aff1">Center for Complex Reconstruction, San Francisco, Calif</nlm:aff>
<wicri:noCountry code="subfield">Calif</wicri:noCountry>
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<front><div type="abstract" xml:lang="en"><p><bold>Objective:</bold>
 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. <bold>Methods:</bold>
 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. <bold>Results:</bold>
 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 (<italic>P</italic>
 = .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). <bold>Conclusions:</bold>
 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.</p>
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Dehydrated Human Amnion/Chorion Grafts May Accelerate the Healing of Ulcers on Free Flaps in Patients With Venous Insufficiency and/or Lymphedema

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

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Abstract

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