Effectiveness of amniotic membrane dressing versus conventional dressing in non-healing lower limb ulcers

Abstract

Context (Background): Non-healing ulcers pose a challenge for a dressing material which will provide an ideal covering with promotion of healing by preventing infection, loss of fluids and the same time adherent to the underlying tissues. The search for such a material of wound dressing led us to human amniotic membrane which promises well with the expectations. Objectives: This study was designed to assess the effectiveness of amniotic membrane dressing over normal saline dressing in the treatment of non-healing ulcer in terms of promotion of epithelialization, biodegradation of the membrane, prevention of wound infection, prevention of exudation at the site. Methodology: The prospective and comparative study done during the period of December 2009 to February 2011 in a tertiary care center. The study group included 200 patients with non healing lower limb ulcers, who consented for the study. 85% glycerol preserved seronegative amniotic membranes were used for dressing in 100 randomly selected non-healing ulcer patients (test group) and normal saline (conventional) dressing were done in rest 100 patients (control group). They were visually analyzed at intervals of 7, 14 and 21 days for epithelialization, infection, exudation and biodegradation and response evaluated by scoring criteria. Results: The observation infers that in 88% of the cases there was complete epithelialization in test group compared to 54% complete epithelialization in control group. There was no exudation by 7 days and membrane peeled off on its own and disappeared at ulcer sites by 21 days in 86 patients treated with amniotic membrane dressing. Infection was observed in 12 of the cases in test group compared to 96% of cases in control group. Interpretation and conclusion: The results prove that amniotic membrane is an effective dressing in non-healing ulcers and acts as an efficient interposition graft to prevent adhesions at ulcer sites in comparison to conventional dressing.