Evaluation of single layer amniotic membrane in the management of nonhealing diabetic foot ulcers: an interim analysis of CAMPX

Authors

  • Thomas E Serena Author
  • Brianna Tramelli Author
  • Emily King Author
  • Dereck Shi Author
  • Gregory Bohn Author
  • Ryan Breisinger Author

DOI:

https://doi.org/10.63676/m04r0s60

Keywords:

interim analysis, diabetic foot ulcer, chronic wounds, tissue regeneration, clinical trial design

Abstract

Background: Diabetic foot ulcers (DFUs) represent a chronic and debilitating complication of diabetes, contributing substantially to patient morbidity, mortality, and economic burden. Despite advances in clinical management, outcomes with the current standard of care (SOC) remain suboptimal, with many ulcers failing to achieve complete closure. These limitations reinforce the need for innovative, cost-effective solutions that promote wound closure.

Methods: This randomized controlled multicenter clinical trial evaluated the efficacy of single layer amniotic membrane (SLAM) plus SOC versus SOC alone in achieving complete closure of nonhealing DFUs over 12 weeks. The primary endpoint was complete wound closure, defined as 100% re-epithelialization without drainage for two consecutive weeks, confirmed by blinded independent review.

Results: In Intent-To-Treat (ITT), the SLAM + SOC arm achieved a 13.1% closure rate versus 8.8% with SOC alone, with findings consistent in the Per-Protocol (PP) population. Additionally, the percent area reduction (PAR) from TV-1 to TV-13 measured weekly with digital photographic planimetry and physical examination were analyzed. For ITT, SLAM + SOC outperformed SOC on both average and median wound‐area reduction.

Conclusion: The interim analysis demonstrated that wounds managed with SLAM products trended toward superiority over those managed with SOC.

References

McDermott K, Fang M, Boulton AJM, Selvin E, Hicks CW. Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers. Diabetes Care. 2023;46(1):209-221. https://doi.org/10.2337/dci22-0043 DOI: https://doi.org/10.2337/dci22-0043

Game F. Classification of diabetic foot ulcers. Diabetes Metab Res Rev. 2016;32 Suppl 1:186-194. https://doi.org/10.1002/dmrr.2746 DOI: https://doi.org/10.1002/dmrr.2746

Fife CE, Eckert KA, Carter MJ. Publicly Reported Wound Healing Rates: The Fantasy and the Reality. Adv Wound Care (New Rochelle). 2018;7(3):77-94. https://doi.org/10.1089/wound.2017.0743 DOI: https://doi.org/10.1089/wound.2017.0743

Lim JZ, Ng NS, Thomas C. Prevention and treatment of diabetic foot ulcers. J R Soc Med. 2017;110(3):104-109. https://doi.org/10.1177/0141076816688346 DOI: https://doi.org/10.1177/0141076816688346

Rice JB, Desai U, Cummings AK, Birnbaum HG, Skornicki M, Parsons NB. Burden of diabetic foot ulcers for medicare and private insurers. Diabetes Care. 2014;37(3):651-658. https://doi.org/10.2337/dc13-2176 DOI: https://doi.org/10.2337/dc13-2176

Wu S, Carter M, Cole W, et al. Best practice for wound repair and regeneration use of cellular, acellular and matrix-like products (CAMPs). J Wound Care. 2023;32(Sup4b):S1-S31. https://doi.org/10.12968/jowc.2023.32.Sup4b.S1 DOI: https://doi.org/10.12968/jowc.2023.32.Sup4b.S1

Published

2025-10-31

Data Availability Statement

The data is proprietary but is available on request to the corresponding author.

How to Cite

Evaluation of single layer amniotic membrane in the management of nonhealing diabetic foot ulcers: an interim analysis of CAMPX. (2025). International Journal of Tissue Repair, 1(1). https://doi.org/10.63676/m04r0s60