A Novel Approach to The Use of Flowable Human Amniotic Fluid for Diabetic Foot Ulcers in High-Risk Veterans Affairs Patients

Abstract

As of 2017, there are 425 million people worldwide who suffer and are affected by Diabetes Mellitus. Among those 425 million people, approximately 34% of people go on to develop diabetic foot ulcers with more than 50% becoming infected. There are many causes of ulcers, including metabolic, biomechanical, traumatic, or post-operative complications. The use of human amniotic fluid has the potential to be an additional treatment for pedal wounds in patients with diabetes mellitus. Indications may include wounds which have prolonged or delayed healing as a result of biomechanical complications, co-morbidities, or failed conservative treatment. This case series explores the effectiveness at topical application of flowable human amniotic fluid in 3 different high risk diabetic patients who all suffered from a pedal ulcer. Each patient had a different location and circumstance for their wound allowing for some variety in surgical planning and wound care decision making. Two of the three patients were able to heal completely within 3 months of initial consult with the remaining patient healing within 4 months of initial consult. Per chart reviewing, all three patients have remained healed at the 1 year follow-up with no evidence of reoccurrence. This series hopes to open a discussion regarding the novel use of topical application of human amniotic tissue as an advanced wound care option for those who may have failed conservative therapy or may be looking for alternative methods to help heal pedal ulcers.