Rodríguez-Valiente Mónica, García-Hernández Ana M, Fuente-Mora Cristina, Sánchez-Gálvez Javier, García-Vizcaino Eva María, Tristante Barrenechea Elena, Castellanos Escrig Gregorio, Liarte Lastra Sergio David, Nicolás Francisco Jose
Department of General Surgery, Hospital Clínico Universitario Virgen de la Arrixaca, Biomedical Research Institute of Murcia (IMIB-Arrixaca), El Palmar, 30120 Murcia, Spain.
Faculty of Nursing, UCAM Catholic University of Murcia, Av. Jerónimos 135, Guadalupe, 30107 Murcia, Spain.
Biomedicines. 2024 Oct 18;12(10):2380. doi: 10.3390/biomedicines12102380.
Chronic wounds are defined as those with disturbances in normal healing. They involve symptoms like exudate, odor, pain or impaired mobility, severely impacting life quality. In the case of patients with additional comorbidities, these are known to aggravate the healing impairment. Amniotic membrane (AM) is gaining attention for its regenerative potential, as it has shown promise in treating hard-to-heal wounds, such as diabetic foot ulcers. This work examines a series of five patients who, while suffering an array of other chronic conditions, were treated with AM for the management of non-healing chronic ulcers. Inclusion criteria involved patients with lesions that have been active at least for six weeks and resistant to multiple treatments, accompanied by complex underlying pathologies affecting cardiovascular, immune or renal functions. Exclusion criteria included untreated active infections and patients undergoing other experimental treatments. The mean age of the patients was 68.4 ± 5.2 years. Wounds were treated once a week with AM, following standardized procedures. The variables measured included pain levels, microorganism presence, wound reduction and the number of AM applications to recovery. The median pain VAS score decreased significantly from seven at the start to two at the end of procedures. Four out of five patients achieved complete epithelialization, while the remaining patient showed significant reductions of 40% in wound size after 14 months. Our results confirm how the application of AM is a safe and effective resource for the management of chronic wounds in patients with serious comorbidities, enhancing patients' quality of life, firstly by reducing pain, later by allowing recovery. Future research, including molecular analyses of wound exudates before and after AM treatment, can contribute to better understanding and fine tuning of this therapeutic resource.
慢性伤口被定义为正常愈合过程受到干扰的伤口。它们伴有渗出液、异味、疼痛或活动能力受损等症状,严重影响生活质量。对于患有其他合并症的患者,已知这些合并症会加剧愈合障碍。羊膜因其再生潜力而受到关注,因为它在治疗难愈合伤口(如糖尿病足溃疡)方面已显示出前景。这项研究考察了五名患者,他们虽患有一系列其他慢性疾病,但接受了羊膜治疗以管理不愈合的慢性溃疡。纳入标准包括伤口至少活跃六周且对多种治疗有抵抗性的患者,同时伴有影响心血管、免疫或肾功能的复杂基础病理状况。排除标准包括未经治疗的活动性感染和正在接受其他实验性治疗的患者。患者的平均年龄为68.4±5.2岁。按照标准化程序,每周用羊膜对伤口进行一次治疗。所测量的变量包括疼痛程度、微生物存在情况、伤口缩小情况以及达到愈合所需的羊膜应用次数。疼痛视觉模拟评分(VAS)中位数从治疗开始时的7分显著降至结束时的2分。五名患者中有四名实现了完全上皮化,而其余一名患者在14个月后伤口大小显著缩小了40%。我们的结果证实,对于患有严重合并症的患者,应用羊膜是管理慢性伤口的一种安全有效的方法,首先通过减轻疼痛,随后通过促进愈合来提高患者的生活质量。未来的研究,包括对羊膜治疗前后伤口渗出液的分子分析,有助于更好地理解和优化这种治疗资源。