Use of Dehydrated Human Amniotic Membrane Allograft (DAMA) to Facilitate Limb Salvage and Function in Patients at High Risk for Amputation

Objective –

The objective of this case series is to establish the efficacy of a DAMA tissue dressing in successful limb salvage and restoration of limb function in patients at high risk for amputation.

Methods-

This series reviews 5 patients with non-healing diabetic and vascular ulcers who were treated with DAMA. Photos will be presented.

Case 1:  89 year old male with severe non-reconstructable PAD, s/p Left BKA with AKA pending due to post op traumatic injury. DAMA applied with wound size 5.0 x 4.7 cm   with 2.3 x 1cm exposed bone. After 8 applications, patient healed and stands in parallel bars with prosthesis.

 

Case 2: 91 year old male with CVA, Diabetes, ABI .49, DFU with exposed tendon w/failed vascular intervention. Wound measured 1.2 x 1.2 x 0.7cm and healed with 2 applications of DAMA. Patient is ambulatory with brace.

Case 3: 67 year old male with Diabetes, R BKA, Charcot L foot, and DFU measuring 2.8 x 2.3 x 0.5cm, healed with 5 applications of DAMA despite significant off-loading challenges.

Case 4: 67 year old male with Diabetes, ABI .79, Right great toe amputation with dehiscence. Received DAMA with wound 1.7 x 1.2 x 1 cm, healed with 1 application.

Case 5: 64 year old male with Diabetes, Right BKA, and pressure ulcer from prosthesis measuring 2.3 x 1.8 with depth to fascia. After 2 months without progress, DAMA applied x 3 with current wound measuring 0.3 x 0.5 cm with continuing progress.

Results –

All 5 pts healed /regained limb function with use of DAMA application.

Conclusions –

Of the diabetic or vascular patients who were non-healing and at risk for amputation, all wounds demonstrated healing or closure on average of 3.8 applications of DAMA. In the 2 amputees, higher level of amputation was avoided.