What it is
Amniotic membrane is the thin inner layer of the placenta that surrounds a baby during pregnancy. When it is donated, processed and preserved, it can be used as a graft, a covering placed on or over a wound or on the surface of the eye. Using amniotic membrane as a wound covering and on the eye surface is the established use of these tissues.
"Skin substitutes" is a broad term for products placed on a wound to cover it and support the wound environment. Some are made from human tissue such as amniotic membrane, some come from animal sources, and some are synthetic or combine materials. They differ in how they are made, how they are regulated and what they are meant to do.
It helps to separate wound coverings from injectable products. Injectable amniotic, umbilical cord, Wharton's jelly and exosome products marketed for joints, pain, hair, skin or "regeneration" are generally not FDA-approved for those uses, and the FDA has warned the public about unapproved regenerative products. Most amniotic products also contain no living stem cells after processing, so they should not be described as stem-cell treatments.
How it’s traditionally been approached
Chronic wounds, meaning wounds that have not closed in an expected time, have usually been approached with a foundation of basic care. That commonly includes cleaning and removing unhealthy tissue, keeping the wound appropriately covered, managing infection, and relieving pressure on the area. For diabetic foot ulcers, that often involves offloading. For venous leg ulcers, compression is often part of care.
Blood sugar management, circulation, nutrition and other health factors are also commonly looked at, because they can affect how the body repairs tissue. Wound care is often a team effort involving primary care clinicians, podiatrists, vascular specialists, surgeons and wound care nurses.
Skin substitutes, including amniotic membrane grafts, have traditionally been considered as an added option in some cases, usually after standard care has been tried. For burns, various biologic dressings and grafts have also been used under clinical supervision. Whether any product is appropriate is a decision for a licensed clinician after an evaluation.
How the right doctor may help
The right doctor may help by first looking at the whole picture: the wound itself, your circulation, your blood sugar, your footwear or compression, your medications and your daily routines. A first visit generally includes a conversation about your history, a look at the wound, and possibly tests. A good provider can explain what they see in plain language.
If a skin substitute or amniotic graft is being discussed, you may want to ask about it directly. Useful questions include: What is this product, and what is its tissue source? What is its FDA status for this use? What are the risks? What are the alternatives, including continuing standard care? What might the total cost be, and have you checked what my insurance covers before treatment?
Coverage questions matter too. Medicare and private insurers have their own rules about which skin substitutes they cover, for which wounds and under what conditions, and those rules can change. Ask the provider's office to help you verify coverage in advance, and ask for a clear explanation of anything you may owe. No provider can promise a result, and a trustworthy one will say so.
The whole-person view
A slow-healing wound is not only a physical matter. Stress, poor sleep, pain, worry about mobility and the daily burden of appointments and dressing changes can all affect how a person feels and copes, and body and mind influence each other. Taking a whole-person view can mean paying attention to rest, nutrition, movement your clinician approves, and emotional well-being alongside wound care.
Some people find that body-based support such as Somatic Experiences helps them feel more settled while living with a long-term health challenge. Others value talk therapy through Therapists.plus to work through frustration, fear or low mood. These are complements to, not replacements for, care from your licensed medical team.
Somatic Experiences: nervous system regulation →Somatic Experiences: embodiment and movement →Therapists.plus: mind body connection →
Keep in mind
- Licensed professionals should guide the care of any wound, especially diabetic foot ulcers, venous ulcers and burns, because infection and complications can become serious.
- Amniotic membrane as a wound covering is established, but injectable amniotic, umbilical cord, Wharton's jelly and exosome products for joints, pain, hair, skin or regeneration are generally not FDA-approved for those uses.
- Results vary and nothing here is a promise or guarantee. Ask any provider about FDA status, tissue source, risks, alternatives, total cost and insurance coverage before treatment.
- For emergencies such as spreading redness, fever, severe pain, a deep or black wound or a serious burn, call 911. If you are in crisis, call or text 988.
Guides in this topic
Doctor types
Frequently asked questions
What is amniotic membrane wound healing?
Amniotic membrane wound healing refers to using donated, processed amniotic tissue as a covering on a wound while the body does its own repair. It is one of several options a licensed clinician may consider, usually alongside standard wound care. Whether it suits you depends on an evaluation.
Is an amniotic graft for a diabetic foot ulcer right for me?
Only a licensed clinician can decide that after examining you and your wound. An amniotic graft for a diabetic foot ulcer is typically considered alongside basics such as offloading, infection control and blood sugar management. Ask your provider about the product's FDA status, risks, alternatives and cost.
Can an amniotic graft help a venous leg ulcer?
It may be considered in some cases, but it is not a guarantee. An amniotic graft for a venous leg ulcer is generally discussed alongside compression and other standard care. A provider can explain whether it fits your circumstances.
What are skin substitutes for wounds?
Skin substitutes for wounds are products placed over a wound to cover it and support its healing environment. They can be made from human tissue, animal tissue or synthetic materials. They differ in regulation and intended use, so ask your provider what a specific product is and how it is regulated.
Does Medicare cover skin substitutes?
Medicare skin substitute coverage depends on the product, the type of wound and the program's current rules, which can change. Coverage often has conditions attached. Ask your provider's office to check your coverage and any out-of-pocket responsibility before treatment begins.
Is amniotic membrane used for burn treatment?
Amniotic membrane has been used as a biologic covering for some burns under clinical supervision. Amniotic membrane burn treatment should only be directed by a licensed clinician, since burns can be serious. For a significant burn, call 911 or seek emergency care.
Educational resource. Amniotic Doctors shares general information and connects people with independent doctors. It is not medical advice, diagnosis or treatment. Talk with a licensed professional about your health.