Authors
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
Abstract
Background: There is a growing tendency toward application of human amniotic membrane (HAM) as a biologic substitute in various tissue injuries where a significant tissue loss is a matter of concern. In gastrointestinal injuries especially duodenal ones, some potential limitations in current surgical techniques contribute to not fully acceptable healing outcomes. Thus, this study was carried out to assess repair with HAM patch for duodenal defect in comparison with simple duodenoraphy in an animal model (dog).
Materials and Methods: A total of 15 male German shepherd dogs weighing 23-27 kg were randomly divided into two groups. Group A with 10 dogs, which were a candidate for duodenal repair by amniotic membrane patch and Group B consisted of 5 dogs perform simple duodenorraphy. A precise control was made to match all conditions except surgical technique. Macroscopic and microscopic features of the healed duodenal lumen in both groups were recorded.
Results: Gross evaluation revealed no difference in luminal diameter in both groups. Statistical analysis of duodenal diameter between both groups after operation also showed no significant difference (Pv = 0.789). Histological assessment indicated less inflammation with better wound healing in Group A.
Conclusion: It seems that repairing duodenal wall defect with HAM would result in better histological outcomes compared with what is seen in simple duodenoraphy in animal models. However, there is no significant difference regarding surgical findings.
Keywords
1. | Kesting MR, Wolff KD, Hohlweg-Majert B, Steinstraesser L. The role of allogenic amniotic membrane in burn treatment. J Burn Care Res 2008;29:907-16. |
2. | Uludag M, Ozdilli K, Citgez B, Yetkin G, Ipcioglu OM, Ozcan O, et al. Covering the colon anastomoses with amniotic membrane prevents the negative effects of early intraperitoneal 5-FU administration on anastomotic healing. Int J Colorectal Dis 2010;25:223-32. |
3. | Yetkin G, Uludag M, Citgez B, Karakoc S, Polat N, Kabukcuoglu F. Prevention of peritoneal adhesions by intraperitoneal administration of vitamin E and human amniotic membrane. Int J Surg 2009;7:561-5. |
4. | Liang H, Li C, Gao A, Liang P, Shao Y, Lin T, et al. Spinal duraplasty with two novel substitutes restored locomotor function after acute laceration spinal cord injury in rats. J Biomed Mater Res B Appl Biomater 2012;100:2131-40. |
5. | Toda A, Okabe M, Yoshida T, Nikaido T. The potential of amniotic membrane/amnion-derived cells for regeneration of various tissues. J Pharmacol Sci 2007;105:215-28. |
6. | Mohammadi AA, Johari HG. Anchoring sutures: Useful adjuncts for amniotic membrane for skin graft fixation in extensive burns and near the joints. Burns 2010;36:1134. |
7. | Thatte S. Amniotic membrane transplantation: An option for ocular surface disorders. Oman J Ophthalmol 2011;4:67-72. [PUBMED] |
8. | Mohammadi AA, Seyed Jafari SM, Kiasat M, Tavakkolian AR, Imani MT, Ayaz M, et al. Effect of fresh human amniotic membrane dressing on graft take in patients with chronic burn wounds compared with conventional methods. Burns 2013;39:349-53. |
9. | Kruse FE, Meller D. Amniotic membrane transplantation for reconstruction of the ocular surface. Ophthalmologe 2001;98:801-10. |
10. | Schimidt LR, Cardoso EJ, Schimidt RR, Back LA, Schiazawa MB, d′Acampora AJ, et al. The use of amniotic membrane in the repair of duodenal wounds in Wistar rats. Acta Cir Bras 2010;25:18-23. |
11. | Nikeghbalian S, Atefi S, Kazemi K, Jalaeian H, Roshan N, Naderi N, et al. Repairing large duodenal injuries in dogs by expanded polytetrafluoroethylene patch. J Surg Res 2008;144:17-21. |
12. | Hosseini SV, Abbasi HR, Rezvani H, Vasei M, Ashraf MJ. Comparison between gallbladder serosal and mucosal patch in duodenal injuries repair in dogs. J Invest Surg 2009;22:148-53. |
13. | Cogbill TH, Moore EE, Feliciano DV, Hoyt DB, Jurkovich GJ, Morris JA, et al. Conservative management of duodenal trauma: A multicenter perspective. J Trauma 1990;30:1469-75. |
14. | Soori H, Naghavi M. Deaths from unintentional injuries in rural areas of the Islamic Republic of Iran. East Mediterr Health J 1999;5:55-60. |
15. | Pandey S, Niranjan A, Mishra S, Agrawal T, Singhal BM, Prakash A, et al. Retrospective analysis of duodenal injuries: A comprehensive overview. Saudi J Gastroenterol 2011;17:142-4. [PUBMED] |
16. | Chen GQ, Yang H. Management of duodenal trauma. Chin J Traumatol 2011;14:61-4. |
17. | Barlas M, Gökçora H, Erekul S, Dindar H, Yücesan S. Human amniotic membrane as an intestinal patch for neomucosal growth in the rabbit model. J Pediatr Surg 1992;27:597-601. |
18. | Uludag M, Citgez B, Ozkaya O, Yetkin G, Ozcan O, Polat N, et al. Effects of amniotic membrane on the healing of normal and high-risk colonic anastomoses in rats. Int J Colorectal Dis 2009;24:809-17. |
19. | Uludag M, Citgez B, Ozkaya O, Yetkin G, Ozcan O, Polat N, et al. Effects of amniotic membrane on the healing of primary colonic anastomoses in the cecal ligation and puncture model of secondary peritonitis in rats. Int J Colorectal Dis 2009;24:559-67. |
20. | Kuriu Y, Yamagishi H, Otsuji E, Nakashima S, Miyagawa K, Yoshikawa T, et al. Regeneration of peritoneum using amniotic membrane to prevent postoperative adhesions. Hepatogastroenterology 2009;56:1064-8. |
21. | Zachariou Z. Amniotic membranes as prosthetic material: Experimental utilization data of a rat model. J Pediatr Surg 1997;32:1458-63. |
22. | Niknejad H, Peirovi H, Ahmadiani A, Ghanavi J, Jorjani M. Differentiation factors that influence neuronal markers expression in vitro from human amniotic epithelial cells. Eur Cell Mater 2010;19:22-9. |
23. | Kobayashi N, Kabuyama Y, Sasaki S, Kato K, Homma Y. Suppression of corneal neovascularization by culture supernatant of human amniotic cells. Cornea 2002;21:62-7. |