Use of Human Amnion for Lower Extremity Repair

INTRODUCTION: Normal wound healing occurs in a well-orchestrated and predictable sequence of events including hemostasis, inflammation, proliferation, and remodeling. These interrelated physiologic processes create a reparative microenvironment characterized by high initial levels of growth factors and other soluble mediators of cell signaling; controlled levels of proteases and bacteria; and functional fibroblasts, keratinocytes, and vascular endothelial cells.1 Cell-mediated regeneration of extracellular matrix (ECM), the largest component of dermal skin layer, remains an integral part of this complex dynamic.1 In acute wounds the provisional wound matrix composed of fibrin and fibronectin provides a scaffold to direct cells into the site of injury, which then participates in secreting ECM. The ECM forms communications signals with cells and between cells through a process known as dynamic reciprocity.1