Viable cryopreserved umbilical tissue (vCUT) reduces post-operative adhesions in a rabbit abdominal adhesion model

Abstract

Post-operative adhesions, a common complication of surgery, cause pain, impair organ functionality, and often require additional surgical interventions. Control of inflammation, protection of injured tissue, and rapid tissue repair are critical for adhesion prevention. Adhesion barriers are biomaterials used to prevent adhesions by physical separation of opposing injured tissues. Current adhesion barriers have poor anti-inflammatory and tissue regenerative properties. Umbilical cord tissue (UT), a part of the placenta, is inherently soft, conforming, biocompatible, and biodegradable, with antimicrobial, anti-inflammatory, and antifibrotic properties, making it an attractive alternative to currently available adhesion barriers. While use of fresh tissue is preferable, availability and short storage time limit its clinical use. A viable cryopreserved UT (vCUT) “point of care” allograft has recently become available. vCUT retains the extracellular matrix, growth factors, and native viable cells with the added advantage of a long shelf life at −80 °C. In this study, vCUT's anti-adhesion property was evaluated in a rabbit abdominal adhesion model. The cecum was abraded on two opposing sides, and vCUT was sutured to the abdominal wall on the treatment side; whereas the contralateral side of the abdomen served as an internal untreated control. Gross and histological evaluation was performed at 7, 28, and 67 days post-surgery. No adhesions were detectable on the vCUT treated side at all time points. Histological scores for adhesion, inflammation, and fibrosis were lower on the vCUT treated side as compared to the control side. In conclusion, the data supports the use of vCUT as an adhesion barrier in surgical procedures.

Temporomandibular Joint Discectomy Followed by Disc Replacement Using Viable Osteochondral and Umbilical Cord Allografts Results in Improved Patient Outcomes

“…21,22 The vCUT is cryopreserved umbilical tissue that retains all structural components of fresh umbilical cord tissue, including viable epithelial cells, fibroblasts, and mesenchymal stem cells native to the tissue. 26 The composition and properties of vCUT are similar to those of placental membranes. However, the vCUT is thicker than placental membrane and can be easily manipulated and sutured at the surgical site.…”

“…[27][28][29][30][31] In a rabbit model, vCUT was shown to prevent the development of postoperative adhesions and support the natural wound healing process. 26 Clinical case studies have reported positive outcomes with the use of vCUT in the surgical repair of tendons, fistulas, and limb salvage. [27][28][29][30][31] To date, no CVOCA and vCUTrelated adverse events have been reported.…”

“…CVOCA and vCUT retain extracellular matrix, growth factors, and viable cells native to the human cartilage and umbilical cord tissue, respectively. 21,26 The viable cells in human cartilage (chondrocytes and their precursors) and umbilical cord tissue (neonatal epithelial cells, fibroblasts, and mesenchymal stem cells) have low immunogenicity. Finally, these grafts do not require matching between donors and recipients.…”

“…[21][22][23][24][25] vCUT is composed of amnion and a mucoid connective tissue known as Wharton's jelly. 26 Umbilical tissue has biological properties similar to that of the amniotic membrane but is thicker than the amniotic membrane and can be easily cut and sutured at a surgical site. Surgical implantation of vCUT in animals and patients led to the reduction of inflammation and prevention of postoperative adhesions, correlating with less pain and faster postoperative recovery.…”

“…Surgical implantation of vCUT in animals and patients led to the reduction of inflammation and prevention of postoperative adhesions, correlating with less pain and faster postoperative recovery. [26][27][28][29][30][31] No adverse reactions have been reported for the CVOCA and vCUT.…”