The Use of Micronized Dehydrated Human Amnion/Chorion Membrane Allograft for the Treatment of Diabetic Foot Ulcers: A Case Series.

Diabetic foot ulcers (DFUs) are a common problem in patients with diabetes and are associated with significant morbidity and mortality. Dehydrated human amnion/chorion membrane (dHACM) allografts have been shown to be effective in the treatment of DFUs. A micronization process produces a dHACM powder that can be sprinkled onto irregular wound surfaces or reconstituted with normal saline for injection into tunneling wounds or wound margins. The author presents a case review of 3 patients with chronic plantar surface DFUs treated with micronized dHACM over a 1-month period. Wound duration was at least 8 months, and 2 out of 3 wounds had failed to heal with cryopreserved human fibroblast-derived dermal substitute before treatment with dHACM. Micronized dHACM (40 mg) in powder form was sprinkled onto the plantar ulcers weekly after sharp debridement, followed by standard topical dressings. Weekly dressing change and wound assessment was conducted to determine the rate of closure. Off-loading shoes were provided. Within 4 weeks of the first dHACM application, all 3 wounds had healed: the first after 2 applications, the second after 3 applications, and the last after 4 applications. No adverse events were observed, and the wounds remained healed after 6 months. In the author's practice, the micronized dHACM allograft was easily applied, clinically effective, and well tolerated as a treatment for plantar ulcers in patients with diabetes.