Amniotic Membrane in the Treatment of Varicose Ulcers: a Center Experience

Amniotic membrane (AM) is an option as a cover in varicose leg ulcers, promoting epithelization. Anti-inflammatory and analgesic proprieties are described, as well as high levels of growth factors and angiogenesis. The costs are inferior to surgical plasty. The aim of this work is to describe the results of AM in the treatment of varicous leg ulcers in a group of patients refractory to the best medical treatment.

A pilot prospective trial was conducted. Thirteen patients were selected for the treatment with AM from an outpatient clinic. The inclusion criteria included: ulcer area inferior to 100 cm2, ulcer size variation inferior to 30% in the last month, duration superior to 2 years and refractory to best medical treatment including compressive therapy. The exclusion criteria were ABI>0,8m active infection, bone exposure, severe myopathy of the low limb and acute decompensation of systemic chronic disease. The first five cases were applied on the enfermary (mean stay 3 days), the last 8 patients were applied in the outpatient clinic. After the treatment behavioral reinforcement was made.

The mean sample age was 56 YO (50-71), 70% were female, 30% were diabetic, and post-thrombotic syndrome was present in 54% (7), only one patient was an active smoker. After 2 years a recurrence was observed in 23% (3) cases.

AM is effective in the treatment of varicose ulcers unresponsive to best medical treatment.