Amniotic membrane for treating chronic cutaneous ulcers: A systematic review and meta-analysis of randomized controlled trials

• Main Authors: Xinglong Liang, Li Zhou, Jun Yan, Shivank Singh, Shantanu Singh, Ching-Wen Chien, Tao-Hsin Tung
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2020-01-01
• Series: Dermatologica Sinica
• Subjects: amniotic membrane; chronic cutaneous ulcers; meta-analysis; randomized controlled trials
• Online Access: http://www.dermsinica.org/article.asp?issn=1027-8117;year=2020;volume=38;issue=3;spage=151;epage=158;aulast=Liang
• ISSN: 1027-8117; 2223-330X

Background: In recent years, many studies have reported that amniotic membrane (AM) is an effective adjuvant for promoting the healing of chronic cutaneous ulcers (CCUs). Objectives: The objective of the present study was to evaluate the efficacy and safety of AM for the topical treatment of CCUs. Methods: A literature search was performed using PubMed, Cochrane Library, and Embase for all related studies from inception to May 31, 2019, without restriction on language. A quantitative synthesis of randomized controlled trials (RCTs) was conducted to compare the effectiveness and safety between the AM therapy and standard of care/conventional treatment by employing a random-effect model. Results: Thirteen RCTs with 947 patients were included in the study. Compared to standard of care (SOC), the relative risk (RR) for the healing rate was 1.99 (95% confidence interval [CI]: 1.75–2.26, P < 0.001). A greater percentage area reduction could be found in AM group (mean difference = 70.00%, 95% CI: 15.82–124.17, P = 0.01). There was no statistically significant difference in pain relief (P = 0.36). The RR for adverse events was estimated 0.54 (95% CI: 0.31–0.93) when compared AM group with SOC group (P = 0.03). Conclusion: This systematic review and meta-analysis indicate that it is effective and safe to use AM as an adjuvant treatment for treating CCUs.