Treatment of Chronic Ulceration of the Legs With Human Amnion

Bennett, J.P.; Matthews, R.N.; Faulk, W. Pagé

doi:10.1016/s0140-6736(80)91616-5

Cited by 96 publications

(52 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Based on the enhancement of the aforementioned biological characteristics, the TG--treated AM may also be considered as a novel tissue engineering scaffold for cell culture applications. Although it is widely reported that the AM exhibits an anti--angiogenic effect, the exact mechanism by which this occurs has yet to be fully elucidated [Dua et al, 2004, Hao et al, 2000Bennett et al, 1980 and1982]. As several studies have also demonstrated a panel of growth factors and/or cells within the AM that may contribute to the upregulation of angiogenesis [Wolbank et al, 2009;Kim and Tseng, 1995;Magnatii et al, 1989], it may be feasible to suggest that the AM itself may solely dictate the pro--or anti--angiogenic response when used in a clinical setting.…”

Section: Discussionmentioning

confidence: 99%

Tissue transglutaminase (TG-2) modified amniotic membrane: a novel scaffold for biomedical applications

et al. 2012

View full text Add to dashboard Cite

The amniotic membrane (AM) is considered as a natural cell culture substrate and has occasionally been exploited in regenerative medicine especially for ocular surface reconstruction and dermal wound healing applications. However, its limited use infers from its relatively weak mechanical strength, difficulty during manual handling and susceptibility to proteolytic degradation in vivo. Therefore, in this study we aimed to enhance the mechanical and biological characteristics of the AM by enzymatic cross--linking it using tissue transglutaminase (TG): a calcium--dependent enzyme capable of forming stable ε(γ--glutamyl)lysine cross--linkages. Using a biological catalyst such as TG should not only prevent denaturation during sample preparation but also minimise the potential of residual chemical cross--linking agents compared to alternative methodologies. Methods: Human AM, sourced from elective caesarean sectioning, were treated with TG, BSA and/or a no--treatment control. Samples were then compared in terms of their physical characteristics (SEM, transparency, mechanical strength, susceptibility to proteolytic degradation), biological characteristics (in vitro cell culture, activation of dendritic cells) and its in vivo biocompatibility/angiogenic capacity (chick chorioallantoic membrane (CAM) assay).Results: Transglutaminase--treated AM exhibited enhanced mechanical strength and greater resistance to proteolytic/collagenase degradation compared to the control(s). SEM imaging of the TG--treated membrane summarised a significantly closer association and greater interconnectivity of individual collagen fibres yet it had no effect on the overall transparency of the AM. In vitro cell culture demonstrated no detrimental effect of TG--treatment on the AM in terms of cell attachment, spreading, proliferation and differentiation. Moreover, an "immune response" was not elicited based on extended in vitro culture with human monocyte--derived dendritic cells (mDC). Interestingly, the TG--treated AM still allowed angiogenesis to occur and in some instances, demonstrated an enhancement compared to the control (n = 5). Conclusion:We hereby demonstrate that treating the AM with the cross--linking enzyme, transglutaminase, results in a novel biomaterial with enhanced mechanical and biological characteristics. Above all, this modified membrane demonstrates greater strength, maintains in vitro cell growth, retains optical transparency and allows angiogenesis to occur without inducing an immune response. Taken together, this study demonstrates the feasibility of transglutaminase as an alternate cross--linking treatment for the production of novel biomaterials and suggests that TG--treated AM may now be more commonly exploited as a therapeutic dressing for ocular or wound applications.

show abstract

Section: Discussionmentioning

confidence: 99%

Tissue transglutaminase (TG-2) modified amniotic membrane: a novel scaffold for biomedical applications

et al. 2012

View full text Add to dashboard Cite

show abstract

“…In 1980, Bennett, Matthews, and Faulk reported the use of fresh AM in the management of leg ulcers as a preparation for skin grafting. Clinical trials and animal experiments have documented that of the biological dressings, the AM is superior to both allograft and xenograft skin [7,11].…”

Section: Discussionmentioning

confidence: 99%

“…Quinby et al emphasized that the immunogenicity of AM is low and rejection is rare [6]. Histological analysis and histopathology biopsy studies on ulcers after treatment with AM have revealed an increase in granulation tissue, connective tissue, formation of basement membrane, and vascular development [7,8]. AM also possesses antifibrotic, anti-inflammatory, angiogenic, bacteriostatic, and thrombolytic properties.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Use of Amnion Transfer in Resistant Nonhealing Venous Leg Ulcers

Francis¹,

Shajimon²,

Bhat

et al. 2013

Indian J Surg

View full text Add to dashboard Cite

In the treatment of venous leg ulcers, after adopting many treatment modalities, at times we are still left with a local indolent problem, "the resistant nonhealing venous ulcer." With repeated surgical procedures failing to obtain a healed ulcer, constant pain, persistent discharging wound, infections, etc., many a patient turn hostile. Also, there comes a dimension of despair in the health feeling of the patient. This prospective study was conducted in 40 patients, who were within the inclusion criteria (January 2006-January 2010, 12 males and 28 females, mean age 45 years). A single amniotic membrane (AM) transfer was done after preparation of the wound, and the parameters were assessed periodically. Follow-up for a minimum period of 1 year in all cases and a maximum period of 3 years in many cases (38) was done. Significant clinical response was defined as an ulcer healing greater than 75 % of the original area. Treatment failure was taken as a persistence or recurrence of more than 25 % of the ulcer area in a 1-year follow-up period. The preliminary results of good ulcer healing and no recurrence are encouraging, even up to 3-year follow-up. This proof-of-concept study demonstrates that AM transfer is useful, safe, inexpensive, readily available, and well accepted by patients, with tremendous potential in promoting epithelial healing in "the resistant nonhealing chronic venous leg ulcer."

show abstract

“…This beneficial effect of wound healing and host phagocyte activity has also been demonstrated when Op-Site, a commercially available semipermeable dressing, is applied to open wounds.3 Many other workers have since used amnion dressings to aid wound healing and confirmed an increased rate of re-epithelialisation, a decrease in pain, and a reduced incidence of infection. [4][5][6] I have used amnion dressings for the treatment of partial thickness burns and deep pretibial lacerations. The main advantage of this treatment has been that the patient has remained fully mobile and an outpatient throughout the whole course of treatment.…”

Section: Anne Ludbrook David Parkinmentioning

confidence: 99%

Pretibial injuries: a common pitfall

Christian¹

1983

BMJ

View full text Add to dashboard Cite

Treatment of Chronic Ulceration of the Legs With Human Amnion

Cited by 96 publications

References 5 publications

Tissue transglutaminase (TG-2) modified amniotic membrane: a novel scaffold for biomedical applications

Tissue transglutaminase (TG-2) modified amniotic membrane: a novel scaffold for biomedical applications

Use of Amnion Transfer in Resistant Nonhealing Venous Leg Ulcers

Pretibial injuries: a common pitfall

Contact Info

Product

Resources

About