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AmnioArmor creates healthy new tissue where Amniocore, Zenith, and Dermacyte failed.

Updated: Nov 29, 2023

Prior to first application of AmnioArmor, patient JU had undergone 36 applications of a combination of Amniocore, Zenith and Dermacyte grafts starting at application of 16u weekly on Dec 16, 2022 moving to 32u weekly as of 1/6/23.


Before I get into sizes and the awful course this patient has endured, I want to explain that she was brand new to the practice, and was and has been exhibiting signs of now much more significant dementia. This was not clear as of the initial 3 months she was seen, as she arrived alone or was dropped off or her husband waited in the waiting room and never spoke to anyone other than front desk. Patient verbalized her issues quite appropriately initially almost all the time and was articulate enough that we had no reason not to believe everything she was telling us. Needless to say hardly any of it was accurate. It was quite a mess to unravel and still is quite frankly. She had no primary care doctor at the time I began seeing her as she didn’t like the one she had chosen and had been waiting a number of months at that point to see her current PCP whom she ultimately saw for the first time at the end of March 2023.


She has concomitant RA and enteropathic arthritis for which she sees rheumatology at the university in Seattle which we also had trouble getting to the bottom of but ultimately realized she had not been taking oral methotrexate at all, which she had always reported. She was on golimumab which was ? maybe controlling her arthritic/bowel symptoms. Patient then became extremely histrionic and nearly completely intolerant of wound care for a number of weeks, her husband had kind of let her be on her own with her meds and she was taking nothing with any regularity. We were confused as her course/reactions/etc, nothing was matching.


Ultimately, pain control was finally better achieved, her cognitive decline was being properly monitored and her rheumatologist changed the golimumab to infliximab in about May of 2023. A few months prior to that we had started her on IM Methotrexate 25mg weekly in hopes of boosting/supporting each biologic and thereby calming down her autoimmune skin condition that was still not responding well to anything we had tried. (IntraLesional Kenalog, multiple courses of prednisone starting at 60mg, Intramuscular Kenalog and a couple of months of doxycycline hyclate 100bid when the wound started to look like it was picking up some early pyoderma and we also had hopes of some anti-inflammatory effects.) Discussion ensued as to whether or not dapsone would be more appropriate, whether methotrexate was appropriate to continue, why she wasn’t improving as we hoped. PG can be a very difficult disease with unpredictable course. We also discussed referral to wound care clinic specifically. This has been problematic as there is a facility in Seattle that the patient’s husband is unwilling/unable to transport her to and from on a multiple times per week basis. There is a wound care facility here in the area but we’ve been hesitant to send her due to her complete lack of pain control initially, then we saw some improvement with biologic graft application which REALLY waxed and waned due to irregular dressing changes and missed appointments and all that was occurring. Finally, we suspect the patient will not tolerate wound care appointments well, and if a wound vac is chosen we worry this could be too painful for her to tolerate at all. We did refer her months ago, and she awaits initial consult. This has been strongly desired by her OTHER dermatologist who sees her every few months (also at the U).


Dressing changes became an issue and weren’t being performed at home, home health was helpful but not enough and we began seeing the patient twice weekly for bandage changes as well. Maceration has been one of our biggest enemies with her wound because it often sits too long before dressing is changed.


This wound presented at 1cm x 1cm x 0.1cm at first visit 9/8/2022.

This very quickly progressed to 2cm x 2cm x 0.2cm by 10/27/22

Despite all attempts at treatment, by Dec 16, 2022 when the first biologic graft was applied, the wound was 3.5cm x 3.5cm x0.3cm now down to early subcutaneous tissue


Prior to first application of AmnioArmor, patient JU had undergone 36 applications of a combination of Amniocore, Zenith and Dermacyte grafts starting at application of 16u weekly on Dec 16, 2022 moving to 32u weekly as of 1/6/23. Wound continued to wax and wane. We would see moments of absolute brilliance with lots of pink, healthy looking granulation tissue centrally, but the wound size overall did not change substantially. By the time I was contacted by the AmnioArmor rep, I was minimally optimistic that this product would do anything more than those prior. The science behind it was interesting, and I discussed it with Dr. Smith and the patient’s husband who agreed that since it was different it was worth a try but we wouldn’t push it too far if it wasn’t showing us that it was worthwhile to continue. First application of AMNIOARMOR GRAFT APPLIED 8/16/2023 8cmx4.5cm x0.8cm wound size was documented in patient chart, but apparently something went wrong and the photo of the wound did not save. Photo representing the wound 8/22/23 at first dressing change.


At Follow up 8/25/23 wound still measured 8cmx 4.5 but tissue was more pink and appeared healthier with new tissue development over tendon


At Follow up 8/25/23 wound still measured 8cmx 4.5 but tissue was more pink and appeared healthier with new tissue development over tendon

9/1/23 Finally seeing less maceration and much healthier appearance of new tissue especially at wound edges



Now at 8 cm x 4cm diameter we see nearly a 5mm improvement in width of wound. Maceration quite a bit better as well.




AmnioArmor Case study
By 9/8/23 still holding steady 8cmx4cmx0.08est

AmnioArmor Case Study
By 9/8/23 still holding steady 8cmx4cmx0.08est

amnioarmor case study
And finally 9/15/23 we see another 0.5cm improvement to 7.5cm x 4cm

AmnioArmor Case Study
And finally 9/15/23 we see another 0.5cm improvement to 7.5cm x 4cm

Overall I have observed a 5mm reduction in both width and breadth of the wound over a 4 week period which is more than I have seen in months.


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1 Comment


Wow! That is increíble…..

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