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Introduction: The fresh amnion membrane is a popular option for wound healing. After cryopreservation, fibroblasts and epithelial cells in the amnion membrane remain viable, but their viability decreases when the membrane is freeze dried. This study focuses on how the storage time of gamma-irradiated freeze-dried human amniotic membrane impacts the levels of important growth factors for wound healing: epidermal growth factor (EGF), transforming growth factor beta (TGF-β), and basic fibroblast growth factor (bFGF). Methods: This was a post-test group experimental design, in which we used enzyme-linked immunosorbent assay tests to measure three growth factor (EGF, TGF-β, bFGF) levels in gamma-irradiated, freeze-dried human amnion membrane derived from three storage groups of fresh human amnion membrane (1 week, 3 months, and 9 months). Results: The 1-week storage group, EGF levels were too low to detect. However, at 3 months, the levels rose to 3.393 pg/mL, and at 9 months, they reached 6.503 pg/mL. Statistical analysis (Mann–Whitney test) showed no significant difference between the 3-month and 9-month groups (P = 0.689). For bFGF, levels were 61.396 pg/mL at 1 week, 36.005 pg/mL at 3 months, and 132.233 pg/mL at 9 months, with no significant differences across groups (P = 0.134). TGF-β levels were 17.469 pg/mL for 1 week, 34.812 pg/mL for 3 months, and 35.449 pg/mL for 9 months, again showing no significant changes (P = 0.069). Conclusion: The study found no significant differences in the levels of EGF, TGF-β, and bFGF in gamma-irradiated freeze-dried human amnion membrane after storage periods of 1 week, 3 months, and 9 months, suggesting that the storage duration does not adversely affect these growth factors. This could have implications for the use of amnion membranes in clinical settings.

Summary:. Lymphedema is characterized by the abnormal accumulation of lymphatic fluid in the skin and subcutaneous tissue owing to impaired lymph flow. This condition may be primary or secondary to other diseases. Most lymphedema occurs in the lower extremities, which greatly interferes with the activities of the patients, especially walking. Further, it may affect the psychological condition of patients. In Indonesia, several patients with severe lymphedema have visited our clinic. In our center, lymphography is not available. However, as our center is a provincial referral hospital, many patients with lymphedema present with severe conditions. Nonoperative and operative treatment is available, including lymphovenous anastomosis. Herein, we present the rare case of a 33-year-old man with severe lymphedema in his left leg for the past 7 years. The patient was diagnosed with stage III secondary lymphedema of the left lower extremity and underwent lymphaticovenular anastomosis using a modification of the Seki method (Seki 2015). Five large lymphatic vessels were identified using methylene blue, and a transverse incision was made approximately 2–3 cm from the skin to the fatty tissue under the superficial fascia. Lymphaticovenular anastomosis was performed using a microscope. On postoperative day 1, the edema in the leg shrank significantly, and 6 months after surgery, the patient’s foot size began normalizing. The patient could wear pants and became more confident.