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A Multicenter, Randomized, Controlled, Clinical Trial Evaluating Dehydrated Human Amniotic Membrane in the Treatment of Venous Leg Ulcers
Serena, Thomas E. Orgill, Dennis P. Armstrong, David G. Galiano, Robert D. Glat, Paul M. Carter, Marissa J. Kaufman, Jarrod P. Li, William W. Zelen, Charles M.
Serena, Thomas E.
Orgill, Dennis P.
Armstrong, David G.
Galiano, Robert D.
Glat, Paul M.
Carter, Marissa J.
Kaufman, Jarrod P.
Li, William W.
Zelen, Charles M.
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Journal article
Date
2022-09-02
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Surgery
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http://dx.doi.org/10.1097/prs.0000000000009650
Abstract
Background: This randomized controlled trial evaluated the safety and effectiveness of weekly and biweekly applications of dehydrated human amnion and chorion allograft (dHACA) plus standard of care compared to standard of care alone on chronic venous leg ulcers. Methods: This open-label randomized controlled trial included patients with chronic venous leg ulcers at eight wound care centers across the United States. The primary endpoint was the proportion of healed ulcers at 12 weeks. Secondary endpoints included the proportion of ulcers achieving 40 percent closure at 4 weeks and the incidence of adverse events. Results: Among 101 patients screened for eligibility, 60 were eligible and enrolled. At 12 weeks, significantly more venous leg ulcers healed in the two dHACA-treated groups (75 percent) than in the standard-of-care group (30 percent) (p = 0.001) even after adjustment for wound area (p = 0.002), with an odds ratio of 8.7 (95 percent CI, 2.2 to 33.6). There were no significant differences in the proportion of wounds with percentage area reduction greater than or equal to 40 percent at 4 weeks among all groups. The adverse event rate was 63.5 percent. Among the 38 adverse events, none were graft or procedure related, and all were resolved with appropriate treatment. Conclusions: dHACA and standard of care, either applied weekly or biweekly, significantly healed more venous leg ulcers than standard of care alone, suggesting that the use of aseptically processed dHACA is advantageous and a safe and effective treatment option in the healing of chronic venous leg ulcers. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, I.
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Serena, Thomas E. M.D.; Orgill, Dennis P. M.D., Ph.D.; Armstrong, David G. D.P.M., M.D., Ph.D.; Galiano, Robert D. M.D.; Glat, Paul M. M.D.; Carter, Marissa J. Ph.D.; Kaufman, Jarrod P. M.D.; Li, William W. M.D.; Zelen, Charles M. D.P.M.. A Multicenter, Randomized, Controlled, Clinical Trial Evaluating Dehydrated Human Amniotic Membrane in the Treatment of Venous Leg Ulcers. Plastic and Reconstructive Surgery 150(5):p 1128-1136, November 2022. | DOI: 10.1097/PRS.0000000000009650
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Lippincott, Williams & Wilkins
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Plastic and Reconstructive Surgery, Vol. 150, No. 5
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