EFFECT OF THE USE OF THE HUMAN AMNIOTIC MEMBRANE IN HEALING OF SURGICALLY INDUCED SKIN DEFECTS IN RABBITS (HISTOPATHOLOGICAL STUDY) | ||||
Alexandria Dental Journal | ||||
Article 18, Volume 43, Issue 2, August 2018, Page 108-115 PDF (1.5 MB) | ||||
Document Type: Original Article | ||||
DOI: 10.21608/adjalexu.2018.57640 | ||||
![]() | ||||
Authors | ||||
Alaa M. Abdel Gawad* 1; Ahmed Mamdouh M. Shaaban2; Adham A. El Ashwah3; Mona AH. Yehia4 | ||||
1BDS, MS, Faculty of Dentistry, Alexandria University | ||||
2Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University | ||||
3Assistant Professor of Oral and Maxillofacial Surgery, Faculty of Dentistry, Alexandria University | ||||
4Professor of Histochemistry and Cell Biology, Histochemistry and Cell Biology department, Medical Research Institute, Alexandria University | ||||
Abstract | ||||
INTRODUCTION: Soft tissue defects in Maxillofacial region remain significant health problems. The correct architecture and function of the vastly diverse tissues of this important anatomical region is mandatory. Amniotic membrane (AM) has been recently proposed as costeffective alternative skin graft. It provides significant benefits by improving the process of wound healing and minimizing scar formation. OBJECTIVES The aim of the present study was to assess clinically and histologically the effect of the use of the human amniotic membrane in healing of surgically induced skin defects in rabbits. MATERIALS AND METHODS: This study was performed on 14 White New Zealand rabbits on which skin defects were created on both sides of their back. The right side was grafted with human amniotic membrane (AM) freshly obtained and cryopreserved (side A), and the left side was left to heal spontaneously by secondary intention (side B). The rabbits were divided later in to three groups according to intervals of evaluation and sacrification (1st week, 2nd and 3rd week postoperative). The wounds were examined for gross morphological evaluation, histological and immunohistochemical studies. RESULTS Percentage of wound closure in AM grafted wounds was significantly higher than control wounds at 1st and 2nd week, but not significant at 3rd week healing wound (P<0.061). Histologically, the wounds of side (A) showed less inflammatory reaction and thicker newly formed epidermis layer. Collagen fibers were arranged in many directions and had higher density than those found in control wounds. Immunohistochemical evaluation showed higher expression of CD31 in side (A) than side (B) wounds indicating better angiogenesis in AM grafted wounds. CONCLUSIONS: AM graft enhanced and speeded up the healing process and wound closure with less scar healthy tissue. | ||||
Keywords | ||||
Amniotic membrane graft; skin defects; Wound healing | ||||
References | ||||
1. Perry M. Maxillofacial trauma--developments, innovations and controversies. Injury. 2009;40:1252-9.
2. Mamede AC, Carvalho MJ, Abrantes AM, Laranjo M, Maia CJ, Botelho MF. Amniotic membrane : from structure and functions to clinical applications. 2012;447–58
3. Ahmad Z, Nouraei R, Holmes S. Towards a classification system for complex craniofacial fractures. Br J Oral Maxillofac Surg. 2012;50:490-4.
4. Tuckett JW, Lynham A, Lee GA, Perry M, Harrington U. Maxillofacial trauma in the emergency department: a review. Surgeon. 2014;12:106-14.
5. Jalali M, Bayat A. Current use of steroids in management of abnormal raised skin scars. Surgeon. 2007;5:175-80.
6. Siemionow M, Papay F, Alam D, Bernard S, Djohan R, Gordon C, et al. Near-total human face transplantation for a severely disfigured patient in the USA. Lancet. 2009;374:203-9.
7. Gomez JH, Schumacher J, Lauten SD, Sartin EA, Hathcock TL, Swaim SF. Effects of 3 biologic dressings on healing of cutaneous wounds on the limbs of horses. Can J Vet Res. 2004;68:49-55.
8. Oh S, Havlen PR, Hussain N. A case of polymicrobial endocarditis caused by anaerobic organisms in an injection drug user. J Gen Intern Med. 2005;20:C1-2.
9. Tracey AK, Alcott CJ, Schleining JA, Safayi S, Zaback PC, Hostetter JM, et al. The effects of topical oxygen therapy on equine distal limb dermal wound healing. Can J Vet Res. 2014;55:1146-52.
10. Kili S, Tümurkaan N, Nsaldi S, Günay C, Üstek Ö, Yilmaz B. Comparison of the effects of some wound healing materials on full thickness skin wounds in rabbits. Turk J Vet Anim Sci. 2002;26:263-72.
11. Eaglstein WH, Mertz PM. “Inert” Vehicles do Affect Wound Healing. J Invest Dermatol. 1980;74:90-1.
12. Salehi SH, As’adi K, Mousavi SJ, Shoar S. Evaluation of Amniotic Membrane Effectiveness in Skin Graft Donor Site Dressing in Burn Patients. Indian J Surg. 2013;77:1-5.
13. Herndon DN, Branski LK. Contemporary Methods Allowing for Safe and Convenient Use of Amniotic Membrane as a Biologic Wound Dressing for Burns. Ann Plast Surg. 2017;78:S9-S10.
14. Elheneidy H, Omran E, Halwagy A, Al-Inany H, Al-Ansary M, Gad A. Amniotic membrane can be a valid source for wound healing. Int J Womens Health. 2016;8:225-31.
15. Ramos-Vara JA. Principles and methods of immunohistochemistry. Methods Mol Biol. 2011;691:83- 96.
16. Agbara R, Obiadazie AC, Fomete B, Omeje KU. Orofacial soft tissue reconstruction with locoregional flaps in a health resource-depleted environment: Experiences from Nigeria. Arch Plast Surg. 2016;43:265-71.
17. Kiliç S, Timurkaan N, Ünsaldi S, Güay C, Istek Ö, Yilmaz BB. Comparison of the effects of some wound healing materials on full thickness skin wounds in rabbits. Turkish J Vet Anim Sci. 2002;26:263-72.
18. Alrubaiy L, Al-Rubaiy KK. Review Article Skin Substitutes: A Brief Review of Types and Clinical Applications. Oman Med J. 2009;24:4-6.
19. Duarte IGL, Duval-Araujo I. Amniotic membrane as a biological dressing in infected wound healing in rabbits. Acta Cir Bras. 2014;29:334-9.
20. Jirsova K, Jones GLA2. Amniotic membrane in ophthalmology: properties, preparation, storage and indications for grafting—a review. Cell Tissue Bank. 2017;18:193-204.
21. Mamede AC, Carvalho MJ, Abrantes AM, Laranjo M, Maia CJ, Botelho MF. Amniotic membrane : from structure and functions to clinical applications. Cell Tissue Res. 2012;349:447-58.
22. Malhotra C, Jain AK. Human amniotic membrane transplantation: Different modalities of its use in ophthalmology. World J Transplant. 2014;4:111-21.
23. Jumper N, Paus R, Bayat A. Functional histopathology of keloid disease. Histol Histopathol. 2015;30:1033-57.
24. Cohen BE, Geronemus RG, Mcdaniel DH, Brauer JA. The Role of Elastic Fibers in Scar Formation and Treatment. Dermatol Surg. 2017;43:S19-S24.
25. Loeffelbein DJ, Baumann C, Stoeckelhuber M, Hasler R, Mücke T, Steinsträßer L, et al. Amniotic membrane as part of a skin substitute for full-thickness wounds: An experimental evaluation in a porcine model. J Biomed Mater Res B Appl Biomater. 2012;100:1245-56.
26. Niknejad H, Paeini-Vayghan G, Tehrani FA, Khayat-Khoei M, Peirovi H. Side dependent effects of the human amnion on angiogenesis. Placenta. 2013;34:340-5.
27. Yazdanpanah G, Paeini-Vayghan G, Asadi S, Niknejad H. The effects of cryopreservation on angiogenesis modulation activity of human amniotic membrane. Cryobiology. 2015;71:413-8.
28. Johnstone CC., Farley A. The physiological basics of wound healing. Nurs Stand. 2005;19:59-65.
29. Ogawa R. Keloid and Hypertrophic Scars Are the Result of Chronic Inflammation in the Reticular Dermis. Int J Mol Sci. 2017;18: E606. | ||||
Statistics Article View: 183 PDF Download: 481 |
||||