Amniotic Suspension Allograft and Fetal Bovine Acellular Dermal Matrix to Treat Complex, Acute, Full-thickness Wounds: A Retrospective Analysis of Safety and Treatment Efficacy.

INTRODUCTION: Comorbidities; inadequate vascularity; exposure of bones, tendons, or other avascular structures; and loss or removal of significant tissue volume all complicate the clinical treatment of patients with large, acute wounds. A number of amniotic tissue products are currently available for wound healing and other applications; one of these is a human amniotic suspension allograft (ASA) consisting of particulated human amniotic membrane and cells from the amniotic fluid from the same human donor. OBJECTIVE: In this study, the use of ASA with a fetal-derived bovine acellular dermal matrix to promote the healing of large, acute, full-thickness wounds is evaluated. The authors herein hypothesize treatment with ASA may allow for the healing of these wounds. MATERIALS AND METHODS: This study consisted of a chart review of 33 patients, with an average age of 42.2 years, and large acute wounds that were treated with a fetal-derived bovine acellular dermal matrix adsorbed with ASA. To the best of the authors' knowledge, this is the first study to date to investigate the usefulness of ASA in wound healing for large, complex, acute wounds. RESULTS: In this study, 30 of 33 patients were confirmed as fully healed, and 3 patients were lost to follow-up. The average wound size was 537.4 cm2, and the average time to split-thickness skin grafting (STSG) was 30.5 days, with an average time of 6.8 days until at least 95% graft take was achieved. Of the patient population studied, 45.5% had 1 or more significant comorbidities, 30.3% had wounds larger than 500 cm2, and 39.4% had exposed bone or tendon. CONCLUSIONS: In a small but challenging population including a high number of patients with comorbidities and exposed bone or tendon, it was found that ASA delivery, along with a dermal matrix, was successful in treating large, complex, acute wounds.