Wound care is among the most serious issues we treat within the podiatric practice overall. While foot wounds can impact anyone, resulting from things such as an accident, fall, misstep or even a compound fracture, our practice most often treats foot wounds that are a result of issues caused by Diabetes. Treating foot wounds and Diabetic foot ulcerations can be difficult due to many factors, but medical advancements in treating traumatic wounds are giving patients excellent healing results by engaging and encouraging the body to complete the healing process.

Understanding Ulcerative Wounds

Our community suffers from a relatively high rate of Diabetes – a result of having an older local population but also as a product of other conditions, such as obesity and genetics. As aforementioned, one of the complications that results from Diabetes is lower limb ulceration, which has the propensity to develop into chronic ulceration. 

Statistics estimate that about a quarter of people who suffer with Diabetes will experience lower extremity ulceration. The appearance of the wound alone is a sign that other complications may be occurring, such as peripheral neuropathy, peripheral vascular disease and persistent hyperglycemia. For more on that, refer to our article on Foot Wound Care. (insert link to foot wound care) 

Chronic ulceration, which refers to an ulcer (or wound) that has failed to heal within a normal timeframe, or continues to re-occur, is categorized as “chronic”. Chronic wounds are those that do not progress in a timely manner through the four phases of wound healing — hemostasis, inflammatory, proliferative, and remodeling.

Treating Chronic or Ulcerative Wounds

One of the great challenges in treating chronic ulceration and foot wound care has been to positively encourage the body to heal itself within what would be considered a “normal” timeframe. A normal wound should go through several phases of redevelopment and regrowth. People suffering from a compromised healing system, and especially those affected by Diabetes, are unable to naturally complete this process, otherwise referred to as complete wound closure. 

Before developing other solutions, it was at times complicated to treat traumatic wounds and Diabetic foot ulcerations. Skin substitutes can be costly or ineffective, and restoring the health of the impacted area depended largely on the overall health of the individual in combination with existing treatments and therapies. In addition, prolonged healing times could result in further infection and the inability to heal altogether. However, Amniotic Membrane Therapy is helping achieve wound closure while simultaneously engaging the area to fully heal by imparting the highly regenerative content they contain. 

Amniotic Therapy in Medicine

One of the greatest additions to the podiatric practice has been the ability to utilize Amniotic Therapies. The inherent makeup of amniotic tissues enables patients to experience dramatic healing progress when otherwise the health of the tissues and limb(s) might be lost entirely. To understand the importance of Amniotic Therapies in podiatry, you first have to understand the significance of Amniotic Therapy in the medical field at large.

What are Amniotic Membrane Allografts (AMAs)?

Amniotic allografts are “sheets” of organic material, derived from maternal amniotic membranes, which include a range of highly regenerative properties. This organic material is packed with amazing properties that are inherent in, and integral for, the health and development of our species. More specifically, Amniotic Membranes used in wound healing consists of three distinct layers: 

  1. Collagen
  2. Biologically Active Cells
  3. Regenerative Molecules

Collectively, these layers include a wealth of specialized proteins and growth factors, including:

  • Proteoglycans
  • Fibronectin
  • Laminins
  • Collagen
  • Stem Cells
  • Fibroblast Growth Factor (bFGF), 
  • Epidermal Growth Factor (EGF), 
  • Keratinocyte Growth Factor (KGF), 
  • Nerve Growth Factor (NGF), 
  • Transforming Growth Factors (TGF) and 
  • Vascular Endothelial Growth Factor (VEGF).
  • Regenerative Molecules
  • Platelet-Derived Growth Factors
  • Metalloproteinases
  • Immunosuppressive Cytokines
  • Epithelial Cells

https://www.podiatrytoday.com/closer-look-role-amniotic-membrane-diabetic-foot-ulcers

Altogether, the combination of these compounds work in synergy to regenerate and strengthen the tissue while reducing the probability of infection and inflammation. The amazing power of the Amniotic Membrane to create “cellular proliferation” has dramatically changed the way we are able to help the body heal itself when otherwise it would be unable to, due to things such as age, genetics or overall health. 

https://www.woundsource.com/blog/amniotic-membrane-explained-what-it-and-how-it-used-in-wound-care 

How Do Amniotic Membranes Facilitate Wound Care?

The process of tissue regeneration with Amniotic Membrane Allografts follows these basic steps:

  1. Create a structure to “cover” the wound
  2. Allows highly active compounds to treat the affected area
  3. Re-generates the immune response
  4. Reduces inflammation
  5. Stimulates the production of new blood vessels
  6. Facilitates tissue remodeling
  7. Wound closure and prevention of recurrence 

Benefits of Amniotic Membranes for Wound Healing

  • Reduces pain when applied to a wound
  • initiates wound healing process
  • contains antibacterial properties
  • non-immunogenic (not rejected by the body)
  • reduces inflammation
  • reduces scar tissue
  • Excellent alternative to skin grafting

What do Amniotic Membranes treat?

  • Wounds
  • Diabetic Foot Ulcers
  • Trauma fractures during surgery)
  • augmentation for tendon repairs 
  • burns
  • ulcers/chronic ulcers
  • traumatic wounds
  • surgical incisions
  • ophthalmic conditions

Amniotic Membrane Skin Substitute from Artacent® Wound

At County Wide Foot, Ankle and Wound Care Associates, we’re proud to use Artacent® WoundArtacent® Wound is the only wound-specific amniotic patch that can be applied with either side facing the wound. Amniotic tissues are safe, natural biologic barriers, with native membranes supplying a wide array of growth factors. The unique design of Artacent® Wound allows for easy manipulation and repositioning, making it a flexible, dependable option for a variety of wound covering applications.

Amniotic Cells in Podiatric Medicine & Beyond

Amniotic Therapy is proving to be a revolutionary treatment for all sorts of chronic issues, such as joint pain, knee pain and tendonitis as well as sports injuries, but are especially helpful in supporting individuals with comprised immune systems or diseases who are unable to naturally regenerate tissues. Amniotic Therapies are available in both “membrane” format and in “flowable” format, so they can be used either to help heal outer tissues or help heal inner injuries. Most notably, Amniotic Therapy is helping the podiatric community to treat and heal injuries without the need for surgical intervention. 

Amniotic Membranes in particular, as we’ve outlined, have dramatically changed the outcomes for patients dealing with previously non-healing wounds or chronic ulceration. Not only have Amniotic Membranes changed the course of care for these patients, but advancements in science have produced an even better version of this wound dressing. 

Now, Dehydrated Amniotic Membranes, which are cleansed, dehydrated and sterilized, are being used in wound care. The finished product can be stored up to 5 years, compared to live Amniotic Membrane dressings, which can only last up to 6 weeks. This has dramatically improved the cost associated with the therapy, making it more accessible to all.

Are you an Amniotic Membrane Therapy candidate?

Only your podiatrist can tell you if Amniotic Membrane Therapy is a proper treatment for your foot wound care or chronic ulceration, but many suggest the therapy as a first line of defense before considering more invasive procedures, such as surgery.

If you’d like to learn more about our Amniotic Membrane Therapy at County Wide Foot, Ankle & Wound Care Associates, please give us a call at 561-369-3300 to set up a personalized consultation with Dr. Desiree Garzon.