Amniotic membrane grafting in patients with epidermolysis bullosa with chronic wounds

Background: Severe forms of epidermolysis bullosa (EB) are characterized by chronic, nonhealing wounds. Objective: We sought to evaluate the usefulness of amniotic membranes in patients with EB. Methods: A retrospective chart review of patients with EB who were treated with amniotic membranes (two patients, 8 applications) was conducted. The primary outcome measure was number of days to complete healing, and the secondary outcome measures were a qualitative wound score, a visual analog scale score, and potential adverse effects. Results: The number of clays to detect a significant clinical response, defined as greater than 50% improvement, was 40.3 +/- 21.2 clays. The median qualitative wound score was 2 (range 0-5). The mean visual analog scale score at last follow-up was 31.4 +/- 26.8. No adverse events were noted. Limitations: Retrospective design, healing assessed by comparing photographs, and partial grafting of some wounds were limitations. Conclusion: This proof-of-concept study revealed the potential usefulness of amniotic membrane grafting in promoting healing of chronic wounds in patients with EB (J Am Acad Dermatol 2010;62:1038-44.)