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THE RISE OF PLACENTAL TISSUE FOR REPAIR AND REGENERATION
During pregnancy, an amniotic sac forms around the developing fetus, creating a protective environment that is maintained until birth. Amniotic tissue is derived from trophoblasts. These cells cover the developing embryo and primarily exhibit major histocompatibility complex (MHC) Class II antigens, not MHC Class I, which are present in all cadaveric tissue and are responsible for rapid rejection of the allograft. The medical use of this special tissue dates back over one hundred years in a variety of applications, and during that time, there has never been a report of disease transmission, graft rejection, or an immune response associated with its use. Unfortunately, due to storage and transportability, its use was limited throughout the remainder of the 19th century, despite success in a variety of clinical applications.


1910
FIRST DOCUMENTED USE OF AMNIOTIC MEMBRANE
SKIN TRANSPLANTATION.
With a Review of 550 Cases at the Johns Hopkins Hospital.

By JOHN STAIGE DAVIS, M.D.,

Instructor in Surgery, Johns Hopkins University; Assistant Surgeon in the Out-Patient Department of the Johns Hopkins Hospital, Baltimore, Md.

Instructor in Surgery, Johns Hopkins University; Assistant Surgeon in the Out-Patient Department of the Johns Hopkins Hospital, Baltimore, Md.


1913
"Ingenious and, as far as we know, a new or substitue for skin grafting using human amnion, the anti-inflammatory and immunomodulaotory nature of amniotic membrane materials is superior to cadaveric skin allografts or pigskin xenografts." JAMA (Stern - 1913)



Placental tissue grafting has been documented historically for over 100 years. Use continued through the early twentieth century but a rise of communicable diseases and lack of appropriate processing and testing methods curtailed its use.



THE RISE OF PLACENTAL TISSUE FOR REPAIR AND REGENERATION
In Dentistry

977 Articles. Excludes stem cells derived from amnion or chorion.
Courtesy of Chen E., Tofe R., Snoasis Medical 2017

The rise of placental tissue for repair and regeneration in dentistry began taking shape in the early 2000s, with a significant increase coinciding with the release of BioXclude in 2010.



THE RISE OF PLACENTAL TISSUE FOR REPAIR AND REGENERATION
In Medicine

In the 1990s, the use of amniotic tissue for ocular / ophthalmology applications caught on and its use for the repair and regeneration of tissue across a variety of medical markets increased rapidly. This was accelerated further as various tissue processing methodologies were developed.




Ophthalmology

Dental

Chronic Wounds

Spine

Sports Medicine

Dehydrated amnion-chorion allograft is used in a variety of medical specialties including:
  • Ophthalmological applications
  • Chronic wounds
  • Orthopedic / spinal applications
  • Sports medicine


MOH'S SURGERY
This application of amnion-chorion demonstrates the capacity for accelerated healing as well as the significant reduction in scar tissue. Thick scar tissue in these cases are not only an esthetic concern, as reducing the potential for complications such as ectropion remains the primary objective.


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Courtesy of MiMedx
    1. Day 1 - Moh's Surgery
    2. Application of EpiFix (Amnion-Chorion)
    3. Week 2
    4. Week 3
    5. Week 4
    6. 10 Months


DIABETIC FOOT ULCER
Patient presents to the emergency room with an infected diabetic foot wound and a history of poorly controlled insulin independent diabetes mellitus. Debridement and amnion-chorion were chosen as a last effort prior to scheduling foot for amputation.


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Courtesy of MiMedx
    1. Prior to Treatment: Total surface area of the wound was 18.76 cm2. Wound was graded as Grade IIB according to the University of Texas Classification System.

    2. After Initial Debridement: After incision, debridement, and drainage of the wound for 10 days combined with IV antibiotics, the wound was debrided a second time. Amnion-chorion was then applied 2 days later, once there were no signs of active infection. After 14 days, a second graft was placed.

    3. 28 Day Result: The wound was now extremely superficial; patient was able to walk with a custom molded shoe at 3 months.