Amniotic membrane dressings: an effective therapy for SSc-related wounds
SIR, SSc is an autoimmune disease reffered to rheumatologists with profound morbidity and mortality. Ninety per cent of patients with SSc will experience RP; the sequellae include variable levels of ischaemia-induced ulceration leading to significant tissue loss. SSc-related digital ulcers (DUs), which occur in ∼50% of patients and reoccur in up to 70% of these patients, are a devastating complication of this disease that influence all aspects of self-care. Lower extremity and elbow ulcerations are also a major source of morbidity and have limited treatment options.
Accepted therapies to heal and/or prevent DUs are often secondarily assessed in RP clinical trials. Consequently, the effectiveness of wound therapy for DUs is often difficult to assess and inconclusive, limited by small sample sizes, lack of randomization, blinding and inconsistent measurements. It is recognized that SSc disease features influence the natural history of DU formation, yet the impact of local DU wound care is unknown. The goal of this study was to evaluate our standard wound care practice using regenerative tissue applied directly to digital and extremity ulceration with digital photography to assess time to healing.