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Background: Standard compression therapy for venous ulcers of the legs does not promote healing. Although autografting accelerates tissue repair, it is difficult to use in patients with concomitant diseases or when multiple grafts are required. The amniotic membrane has been used as a covering material and promotes epithelialization, making it a good potential treatment option when autografts are not indicated., Objectives: To analyze the literature on the safety and efficacy of amniotic membrane grafting and compare the cost of currently available grafts (autografts, amniotic membrane grafts, and biocompatible skin substitutes) to promote tissue repair in venous ulcers., Material and Methods: A systematic review of the literature on the use of amniotic membrane grafts for the treatment of venous ulcers was performed up to 2010. A cost-minimization analysis of direct healthcare costs was then performed (at 3 and 6 months). A sensitivity analysis was performed to confirm the stability of the results., Results: Only 1 study addressing safety and efficacy was identified. The cost-minimization analysis showed that autografts are always the least-expensive option (€ 1053 compared with € 1825 for amniotic membrane grafts and € 5767 for biocompatible skin grafts). At 6 months, however, amniotic membrane grafts would have cost € 6765 less than the use of biocompatible skin substitutes., Conclusions: Despite having excellent therapeutic potential for the re-epithelialization of venous ulcers that do not respond to conventional treatment, amniotic membrane transplant remains an experimental therapy. Autograft is the most efficient treatment but amniotic membrane graft is less expensive than the use of biocompatible skin substitutes., (Copyright © 2010 Elsevier España, S.L. y AEDV. All rights reserved.)

Treatment for varicose ulcers is based on treating an ulcer as a chronic injury and its primary cause, hypertension in the veins, by means of a system of decreasing and sustained high compression. In Spain patients suffering from varicose ulcers are treated mainly with systems based on the use of crepe bandages which have a low compression effectiveness. In order to bring to light information on this important facet of health care and to generate evidence on this topic, the authors present a comparative study of a standard therapy method utilizing compression on patients suffering from varicose ulcers in Spain, a crepe bandage, against the use of a Profore multi-layer system. The authors studied 30 varicose ulcers on 24 patients who met the criteria to be included in this study; 17 of these, 70.8%, in women and 7, 29.2%, in men. The average treatment period of these lesions with crepe bandages on these lesions was 1045 +/- 2370 (DS) days (mean of 120). At the start of treatment with the multi-layer system, the average lesion surface area reached 10.64 +/- 9.45 (DS) cm2 (mean 7.28). After treatment with this multi-layer system, all these lesions cicatrized entirely. In order for this to happen, an average of 43.73 +/- 27.38 (DS), (mean 34) was required. Based on our results, we can state that the use of the multi-layer system in this study compared to a crepe bandage allowed for the reduction in cicatrisation time, in the number of bandage changes, in the number of visits, in the professional time needed, and reduced by a factor of 20 the cost of the material involved.