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

Abstract

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.