Quantification of neovascularisation in chronic non healing ulcers after amniotic membrane dressing vs collagen sponge application

Collagen sheath and amniotic membrane has unique properties like enhanced wound healing through neovascularisation, anti adhesive effects, bacteriostatic, without inducing immunological reactions. There are no studies to quantify neovascularisation with any agent applied to chronic non healing ulcers. This is a comparative study between collagen sheath and amniotic membrane application. This study is done to evaluate effects of healing in chronic ulcers as evidenced by quantum of neovascularisation by collagen sheath and amniotic membrane application for a period of eight weeks in 30 patients, 15 patients with collagen sheath and 15 patients with amniotic membrane. Collagen sheath is commercially available. Amniotic membrane is to be harvested from placenta taken from caesarean section and applied over ulcers. Patients are evaluated at first, second, fourth, sixth and eighth week. In the first two weeks there is faster rate of neovascularisation as seen by counting the number of capillaries in an average of five high power fields (p-value 0.000), later on there is congestion of vessels with formation of granulation tissue which peaks at fourth week (p- <0.0001), leading to reduction in ulcer size. When compared to collagen sheath amniotic membrane showed significant increase in number of capillary formation per high power field (p- <0.0001). There is significant reduction in ulcer size (p- 0.000) with both collagen sheath and amniotic membrane, inter alia there is no significant difference in decrease in ulcer size between collagen sheath group and amniotic membrane group (p->0.05). The cost effectiveness, readily availability, ease of application makes collagen sheath a better choice for treating chronic ulcers.