Time Does Not (Always) Heal All Wounds: Seven-Year Recalcitrant DFU Treated Using Tri-Layer Amnion/Chorion/Placental Membrane Tissue (RE-AC)

Introduction: Diabetic patients pose complex extrinsic and intrinsic challenges that require a multifactorial approach to wound healing using more advanced technologies including human placental membrane tissues. Despite ongoing and escalating interventions, some patients are refractory to treatment. We present an 87-year-old patient with a non-healing ankle ulcer that was recalcitrant to standard wound care management for approximately seven years.Methods:After seven years of treatment elsewhere, I assumed wound management implementing standard of care interventions at skilled nursing facility.  After multiple weeks of no improvement, full thickness, tri-layer amnion/chorion/placental membrane tissue (RE-AC) was placed and secured in wound bed and covered with absorbent antimicrobial bordered dressing. Membrane application was applied every 7-10 days.  Results:After 3 applications of RE-AC, there was 46% wound area reduction. The patient has increased compliance in rehabilitation goals, glycemic control and is tolerating diabetic-friendly liquid protein supplementation.  Discussion: The findings suggest that RE-AC can offer more rapid healing rates versus standard-of-care wound care management. This efficiency can lead to improved patient comfort and quality of life, reduced treatment costs, and optimized resource utilization in healthcare settings.References:Bose D, Meric-Bernstam F, Hofstetter W, Reardon DA, Flaherty KT, Ellis LM. Vascular endothelial growth factor targeted therapy in the perioperative setting: implications for patient care. Lancet Oncol. 2010;11(4):373-382. doi:10.1016/S1470-2045(09)70341-9