Evidence-Based Practice

To review data from the Centers for Medicare and
Medicaid Services (CMS) database in order to compare clinical
outcomes of patients who were treated with Artacent Wound and
Artacent AC (Tides Medical, US), a dual-layer amniotic membrane
(DLAM), with patients who received debridement alone.
Methods:
A retrospective cohort study was conducted using a 1:1
matching procedure based on six pre-specified baseline covariates
of Medicare patients who received DLAM or debridement alone for
the treatment of lower extremity diabetic ulcers (LEDUs) between
2020 and 2023. LEDU episodes were constructed from claims data
by linking sequential services until a 60-day clean period without
LEDU-related claims was observed, which signified the end of an
episode. Outcomes assessed within each completed episode
included major and minor amputations, as well as emergency
department (ED) visits, hospital readmissions, or care transitions to
other sites of service, such as skilled nursing facilities.
Results:
There were >2 million eligible episodes identified in the
CMS database, of which 1244 LEDU episodes (622 in each cohort)
met study eligibility and were analysed. Based on the analysis,
approximately one major amputation was prevented for every
32 patients treated with DLAM as compared to debridement alone.
Inpatient admissions, ED visits and skilled nursing facility visits were
significantly reduced in the DLAM cohort.
Discussion:
Medicare patients treated with DLAM experienced
significantly lower rates of major amputations and reduced
healthcare use compared with those treated with debridement alone.
Promising results from this study may provide another advanced
wound care option to add to the treatment armamentarium.