The use of human amnion/chorion membrane in the clinical setting for lower extremity repair: a review.

Unsuccessful healing represents a significant medical dilemma for both patients and clinicians and create a financial burden on the health care system. Despite the efforts of physicians, many injuries fail to heal with standard care alone. For decades human amniotic membrane composed of both amnion and chorion has shown remarkable therapeutic potential, but only recent preservation methods have allowed its widespread use. Variations in configurations and the ability to micronize the material allow clinical uses that were previously not possible. Although there are limited data available regarding most amniotic membrane-based products, there is substantial preclinical and clinical evidence supporting the rationale and effectiveness of dHACM allograft as a treatment modality. The rapidly growing body of evidence suggests that the properties inherent in dHACM promote tissue regeneration and healing, recruiting patients' own stem cells into the wounded area. Randomized controlled trials evaluating dHACM now include more than 200 patients collectively and the results consistently show improved healing. Use of dHACM has been shown to be more clinically effective and cost-effective than other frequently used advanced wound care products. This cost-effectiveness results from dHACM showing higher healing rates and more rapid healing than other advanced wound care products. Cost-effectiveness is also enhanced through the availability of grafts of multiple sizes, which reduces wastage, and through ease of handling and storage for clinical use. Ongoing and future studies will further define and establish the value of amniotic membrane for chronic tissue repair and regeneration.