Effect of the Mode of Application of Cryopreserved Human Amniotic Membrane on Adhesion Formation after Abdomino-Pelvic Surgery in a Mouse Model

Abstract

Adhesions after abdomino-pelvic surgery are a cause of morbidity and reoperations. The use of human amniotic membrane (HAM) for adhesion prevention has given controversial results. The mode of administration of the amniotic membrane has not been well studied. This study assessed the efficacy of two modes of application of cryopreserved HAM, patch or fragmented in Lactated Ringer (LR) solution, for the prevention of pelvic adhesion formation postabdomino-pelvic surgery in a mice model. After a midline laparotomy incision, a small cautery lesion was done on each side of the abdominal wall peritoneum in mice. In Group A (control; n = 42), the abdomen was closed directly, Group B (n = 42) received 2.5 ml of LR prior to closure. In Groups C (n = 42) and D (n = 42), a 2 cm × 2 cm patch of HAM and another one fragmented and dispersed in 2.5 ml of LR were applied prior to closure, respectively. Two weeks later, a laparotomy was performed, and gross and pathological evaluation of adhesions, fibrosis, angiogenesis, and inflammation were conducted. Group D exhibited a significantly lower rate of gross adhesion formation. Fibrosis was significantly lowest in Group C as compared to the control. Group B had the lowest vascular formation in the adhesions. The use of HAM fragmented in LR solution is associated with a significantly lower incidence of postoperative adhesions in mice when compared to LR alone, HAM patch, or control. The mechanism of action of this reduction needs to be elucidated by future studies.

Human Placental Mesenchymal Stem Cells for the Treatment of ARDS in Rat

“…There are examples effective application of placenta tissue in abdominal and pelvic surgeries [58,59], cardiac surgery [60,61], for wound healing [62,63], for treatment of acute chemical or thermal burns [64], in ophthalmology, for ocular surface reconstruction, including the treatment of persistent epithelial defects and nonhealing corneal ulcers [65], and etc.…”

Effects of stem cells and amniotic fluid on uterus and ovaries in a rat model of abdominal adhesions: a controlled study

“…Studies to prevent intra-abdominal adhesions after surgery have been ongoing since the beginning of the last century ( 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ). Considering the significant postoperative complications caused by adhesions, such as second surgery, ileus, pain, intraoperative complications in further surgeries, and infertility, initiating an effective treatment is clinically available ( 1 ).…”

“…The regenerative characteristics of hUCMSCs and AF play a significant role in treating and preventing adhesions. Additionally, several animal studies utilising AFSCs have been published ( 33 , 34 , 35 , 41 ). However, adult stem cells have a limited capacity for regeneration, and foetal stem cells may be ethically unacceptable.…”

“…In a study by Canbaz et al ( 18 ) in a rat model, gonadotropin-releasing hormone agonist therapy successfully reduced postoperative adhesion formation but was not superior to intraperitoneal Ringer’s lactate solution. An increasing number of studies ( 19 ) have researched the adhesion prevention capability of various barrier agents ( 20 , 21 , 22 , 23 ), various combination gels ( 24 , 25 , 26 , 27 , 28 , 29 ), biomaterials ( 30 ), growth factor inhibitors ( 31 , 32 ), and stem cells ( 33 , 34 , 35 ), which is evidence of the importance of adhesion-related problems.…”

A Review on Modifications of Amniotic Membrane for Biomedical Applications

“…Following that in 1913, Stern and Sabella utilized AM for the treatment of skin burns and superficial wounds ( Islam et al, 2015 ). Since then, AM has been employed for numerous applications, including disorders associated with the urinary tract ( Barski et al, 2017 ; Fénelon et al, 2018 ), oral cavity ( Anisuzzaman et al, 2018 ; Farhadihosseinabadi et al, 2018 ), skin ( Orman et al, 2018 ), stomach ( Iravani et al, 2020 ), larynx ( Turchan et al, 2018 ), head and neck ( Şapte et al, 2017 ; Jorge et al, 2018 ), ocular surface ( Gheorghe et al, 2016 ; Nassif et al, 2016 ), pelvic and abdominal surgery ( Lau et al, 2020 ), and artificial vaginal reconstruction ( Mao et al, 2016 ; Figure 2 ). All of these applications are the result of the interesting features of AM ( Table 1 ).…”