Injection of Cryopreserved Amniotic Membrane and Umbilical Cord Particulate for Pressure Injuries: A Retrospective Case Series

Abstract

Introduction. PI poses a significant burden to society. Cryopreserved AMUC has potential benefits in managing complex wounds owing to its anti-inflammatory, anti-scarring, and proregenerative properties. AMUC grafts are commonly in sheets, but also come as morselized powders that can be sprinkled or injected. The authors initially used AMUC injection in chronic PIs in March 2017. Materials and Methods. This is a single-center, retrospective review of patients with nonhealing PIs treated with AMUC particulate between March 2017 and November 2018. Incidence of wound healing (zero wound volume with complete reepithelialization) was measured at 12, 24, 36, and 52 weeks. Results. Review included 26 PIs (21 patients); of which, 85% were stage 4 PIs, per the NPIAP staging system. After AMUC injection, 14 PIs (54%) achieved complete wound closure at a median of 12.4 weeks (range, 5–52 weeks). Complete wound closure was observed in 7 patients (27%) at 12 weeks, 10 patients (38%) at 24 weeks, 13 patients (50%) at 36 weeks, and 14 patients (54%) at 52 weeks. One patient with vascular issues required amputation; however, no treatment-related adverse events or complications were observed. Conclusions. These preliminary results suggest that injection of AMUC particulate may be a safe and promising treatment in promoting wound closure of difficult-to-treat PIs.