(CS-037) Aseptically Processed Dehydrated Allograft Placental Membrane For Limb Salvage Reconstruction

Krista Bauer, RN, WCC, OMS; Kari Day, RN, BSN, WCC; Ashley Wardman, CPPM, Surgical LPN-C

Introduction: Surgical reconstruction as a “ last resort attempt at limb salvage” is challenging and comes with a significant burden of limb loss if failure occurs. Previously, we reported the use of placental allografts for incisional management following surgical closure of chronic wounds,

Placental allografts provide native matrix proteins and encourage wound progression. While incisional management following closure of chronic wounds may benefit from the addition of aseptically processed dehydrated allograft placental mini membrane to assist in optimizing the tissue for surgical healing, the value of the supportive tissue is priceless when failure results in limb loss.

Methods: We present 5 cases utilizing placental allograft as a mini matrix prior to optimize outcomes following reconstruction in the setting of potential limb loss of the lower extremity (hardware infection: Knee: n-2, Ankle-n=1: Chronic infection without hardware: Knee: 1, Ankle n=1.)

The dehydrated placental mini membrane was placed prior to incision closure and or over a skin graft. Negative pressure was applied postoperatively and continued for 7-10 days.

Results: Primary healing was achieved in all cases without postoperative infection and/or surgical site dehiscence. In 1 case, the patient had a small area of dehiscence which was managed non operatively and healed without further surgical intervention.

Discussion: The addition of dehydrated allograft placental mini membrane without terminal sterilization to surgical reconstruction may improve surgical outcomes. While the exact mechanisms are not known, the aseptically processed placental tissue without terminal sterilization is known to maintain the inherent growth factors and native matrix proteins, which supports wound closure and secondary healing. We found that surgical outcomes were encouraging in the face of chronic infection with and without hardware present. Additionally, in those cases that had incomplete surgical healing, the wounds healed and or progressed without recurrent infection.