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A Case Series Using EpiFix, A Dehydrated Human Amnion/Chorion Membrane (DHACM), In The Treatment Of Patients With Wounds That Are Hard To Heal.

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dHACM (EpiFix® MiMedx Group, Inc., Marietta, GA) is a dehydrated human amnion/chorion membrane allograft. It is derived from amniotic membranes donated with informed consent in the US and terminally sterilised to reduce virus transmission. It contains growth factors that are required for normal wound healing, and it is intended to enhance healing, modulate inflammation and reduce scarring. There is level 1 evidence from randomised control trials that dHACM improves healing rates in venous leg ulcers1 and chronic lower extremity diabetic ulcers2. It is currently used in the US for a variety of chronic and acute wounds.

We present some of the preliminary findings from an ongoing evaluation of dHACM allograft, the first in the UK. The dHACM was applied to non-infected hard to heal chronic wounds weekly for four weeks. If required, sharp debridement was performed prior to application. Patients were followed up for 12 weeks in total.

•To date, 5 of 6 patients received all 4 dHACM applications with follow-up visits ranging from 1-12 weeks.
•These five patients saw an average wound area reduction of approximately 69.04%.
•An increase in the percentage of granulation tissue was observed for all of the patients.
•There have been no reported adverse effects and all patients have accepted and tolerated the treatment well.

Conclusion: There may be a role for the use of dHACM as a treatment to stimulate the healing trajectory toward wound closure in hard to heal wounds.

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