Treatment of large, complex, non-healing wounds with cryopreserved amniotic suspension allograft: a case series.
OBJECTIVE
Cryopreserved amniotic suspension allograft (CASA) is a regenerative tissue suspension containing amniotic membrane and amniotic fluid components used for soft-tissue repair, replacement, and reconstruction. The aim of this case series is to examine its effects in different wound types.


METHOD
In a retrospective series CASA was applied to chronic non-healing wounds. All patients were treated at a single center between June 2013 and December 2014. The criterion for application of CASA was lack of progress toward wound healing despite standard treatments and adjuvant therapies.


RESULTS
We assessed five patients aged between 39 to 86 years old. Three patients had surgical/radiation wounds, one had a sacral pressure ulcer, and one had a diabetic foot ulcer (DFU). All patients experienced progressive improvement in wound area and volume during treatment with CASA. One patient (postmastectomy tissue necrosis) required surgical closure in conjunction with removal of retained sutures. CASA applied topically and subcutaneously was particularly well suited to application in these wounds with large sinus tracts or undermining. All five patients experienced complete wound closure following one to two applications of CASA over 5 to 22 weeks.


CONCLUSION
This series highlights the effective use of CASA in recalcitrant large soft-tissue wounds, DFUs, and deep wounds with tendon exposure.


DECLARATION OF INTEREST
This study was supported by a grant from Derma Sciences (Princeton, NJ, US).
['Marcus|B|B|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D064591:Allografts D000650:Amnion D015925:Cryopreservation D017719:Diabetic Foot D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012189:Retrospective Studies D014945:Wound Healing
pressure ulcer diabetic foot ulcer advanced wound care amniotic allograft radionecrosis surgical wound