Skin substitutes made from donated amniotic tissue are used in dermatology to transform chronic wounds into an acute state, improving the healing environment. These substitutes significantly enhance healing rates, reduce emergency admissions, and decrease the need for amputations when used alongside quality care practices like debridement and offloading.
Physician’s Weekly spoke with David Armstrong, MD, PhD, professor of surgery and neurological surgery at the Keck School of Medicine of the University of Southern California, to better understand the benefits of skin substitutes.
Can you explain how skin substitutes, particularly those made from donated amniotic tissue, can treat chronic wounds?
Dermatologists, like anyone with significant specialties in wound healing, may want to use products like this because they do not necessarily serve like a skin graft but work in many ways, like an immune modulator. In doing that, they help transform the histology of the wound from one that is more of a chronic profile to one that is more of an acute profile.
It can make the wound environment much less hostile and help prepare the wound for closure.
What are the typical outcomes you’ve observed when using skin substitutes?
The data now point in one direction across the United States and worldwide: using skin substitutes is associated with a higher rate of healing, a lower rate of emergency department admission, a lower rate of foot-level limb sparing, and a lower rate of amputations and high-level amputations.
From all those perspectives, we see a net positive when used appropriately and with other good quality care, like good quality debridement, good quality offloading, pressure protection, and an interdisciplinary management team because it takes a team here. No clinician is an island here; putting those folks together can affect positive change.
What are the potential risks associated with not having access to these substitutes?
The risks could include a lack of access to these and a longer time to healing. Time is tissue, and the longer these wounds are open, the greater they are at risk of getting infected and then hospitalization.
Once one of these patients is hospitalized, especially people with diabetes, about 20% of those hospitalizations will end up in some form of lower extremity amputation. And that’s why there’s an amputation every 20 seconds worldwide. And this is something that we as a family can do something about. We can marry technology with our team and a little tenacity to make a difference.
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