Paggiaro AO, Menezes AG, Ferrassi AD, De Carvalho VF, Gemperli R, et al.
Journal of wound care. Date of publication 2018 Feb 1;volume 27(Sup2):S19-S25.
1. J Wound Care. 2018 Feb 1;27(Sup2):S19-S25. doi: 10.12968/jowc.2018.27.Sup2.S19.
Biological effects of amniotic membrane on diabetic foot wounds: a systematic
review.
Paggiaro AO(1), Menezes AG(2), Ferrassi AD(2), De Carvalho VF(1), Gemperli R(3).
Author information:
(1)Professor, Guarulhos University, Brazil.
(2)Senior Nursing Student, Guarulhos, São Paulo, Brazil.
(3)Plastic Surgery, Professor, São Paulo University, Brazil.
OBJECTIVE: The amniotic membrane has biological properties that are beneficial to
the wound healing process of diabetic foot ulcers (DFU). Our aim is to analyse
the scientific evidence found in literature on the use of the amniotic membrane
to stimulate DFU healing.
METHOD: A systematic review of amniotic membrane's influence was undertaken,
using the search terms 'placenta' 'diabetic foot' 'amnion' and biological
dressing', assessing the outcomes 'wound healing' and 'wound healing time', in
DFU. Following the inclusion and exclusion criteria, randomised controlled trials
(RCT) were identified, and the risk of bias was analysed according to the
Cochrane risk of bias tool. We conducted a meta-analysis of the two outcomes to
evaluate the level of evidence.
RESULTS: We identified six clinical trials, with a total of 331 patients. The
most common risks of bias in the studies were selection, attrition, and detection
biases. From the meta-analysis, although the result difference of the
intervention group (amnion) in relation to the control group was not
statistically significant, we found that wound healing in the group treated with
amniotic membrane occurs 2.32 times more often and is 32 days faster in
comparison with the group that used conventional dressings.
CONCLUSION: There is no statistical evidence to support the effectiveness of
amniotic membrane in comparison with other conventional dressings. However, there
is a clear tendency for the use of amniotic membrane treatment to result in a
larger number of DFUs healing at a quicker rate.
DOI: 10.12968/jowc.2018.27.Sup2.S19
PMID: 29419367