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Publications library Research article

J Comp Eff Res · 2020

A randomized controlled clinical trial of a hypothermically stored amniotic membrane for use in diabetic foot ulcers

Serena, T.E., Yaakov, R., Moore, S., Cole, W., Coe, S., Snyder, R., Patel, K., Doner, B., Kasper, M.A., Hamil, R., Wendling, S., & Sabolinski, M.L.

Journal of Comparative Effectiveness Research (Future Medicine)

In brief

This multicenter randomized controlled trial at 14 US centers compared a hypothermically stored amniotic membrane (HSAM) plus standard care with standard care alone (debridement, dressings and total contact casting) in 76 patients with diabetic foot ulcers that had not responded to standard care. Wound closure, the primary endpoint, was significantly more frequent with HSAM at 12 weeks (55 vs 29%; p = 0.02) and 16 weeks (58 vs 29%; p = 0.01), and more HSAM-treated ulcers reached a greater than 60% reduction in area (82 vs 58%; p = 0.02). The trial was open label, closure was defined from digital measurements as an ulcer area between 0 and 0.1 cm2, and the study was funded by Organogenesis, Inc.

Co-authored by SerenaGroup researchers.

Plain-language summary by SerenaGroup. See the full text for complete methods and results.

Abstract

Determine the effectiveness of hypothermically stored amniotic membrane (HSAM) versus standard of care (SOC) in diabetic foot ulcers (DFUs). Methods: A randomized controlled trial was conducted on 76 DFUs analyzed digitally. Results: Cox wound closure for HSAM (38 wounds) was significantly greater (p = 0.04) at weeks 12 (60 vs 38%), and 16 (63 vs 38%). The probability of wound closure increased by 75% (Hazard Ratio = 1.75; 95% CI: 1.16–2.70). HSAM showed >60% reductions in area (82 vs 58%; p = 0.02) and depth (65 vs 39%; p = 0.04) versus SOC. Conclusion: HSAM increased frequency and probability of wound closure in DFUs versus SOC. First draft submitted: 23 September 2019; Accepted for publication: 21 October 2019; Published online: 6 November 2019

Keywords

clinical trialsdiabetesHSAMhypothermically stored amniotic membrane