Retrospective Evaluation of Human Amniotic Allografts for Diabetic Foot Ulcers and Venous Leg Ulcers Treated by an In-Home Mobile Wound Clinic.

Background: The objective is to evaluate the differences in the efficacy of wound care algorithms for diabetic foot ulcers (DFUs) and venous leg ulcers (VLUs) treated by a mobile wound clinic. Most patients requiring home treatment performed worse with the standard of care (SOC) compared to those in traditional outpatient clinics, especially chronic wounds associated with multiple comorbidities.

Methods: A retrospective chart review was conducted on one year's data from patient records of a mobile wound clinic (July 2022 - June 2023) involving patients suffering from DFU and VLU. Patients were divided into a control group receiving SOC with debridement and a group receiving SOC plus placental-based tissue grafts. The wound area and depth were assessed weekly. The SOC plus grafting group was monitored for the duration and number of graft applications per wound. Wounds were also scored for granulation-epithelialization (G+E) and eschar-slough (E+S). Statistical analysis included paired t-tests and ANOVA for multiple comparisons.

Results: In the interventional group, the average reduction in wound area was 39%, compared to a 10% reduction in the SOC with debridement cohort (p < 0.05). The average wound depth decreased by 33% in the interventional group and by 2% in the SOC with debridement cohort (p<0.05). The interventional group improved their positive wound scores by 8% (G+E), while negative wound scores decreased by 55% (E+S) compared to SOC with debridement patients. The mean grafting period was 94 days (±10 days) per patient, with a mean of 15 grafts (±2.6) applied per wound.

Conclusion: Despite severe comorbidities, we observed improved wound healing in a home-based care setting for most DFU and VLU patients who underwent SOC with debridement and grafting compared to SOC with debridement alone. Patients receiving SOC alone showed poorer performance at home compared to those receiving SOC plus grafting, consistently showing improvement over time.