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In Vitro Culture of Epithelial Cells from Different Anatomical Regions of the Human Amniotic Membrane
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In Vitro Culture of Epithelial Cells from Different Anatomical Regions of the Human Amniotic Membrane

Published on: November 28, 2019

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Human-Derived Amniotic Membrane Is Associated With Decreased Postoperative Intraperitoneal Adhesions in a Rat Model

John P Kuckelman1, Joseph Kononchik2, Joshua Smith1

  • 1Department of General Surgery, Madigan Army Medical Center, Tacoma, Washington.

Diseases of the Colon and Rectum
|March 10, 2018
PubMed

Insights

Human amniotic membrane significantly reduced post-surgical adhesions in rats compared to hyaluronic acid barriers. This study suggests amniotic membranes are a promising alternative for preventing intraperitoneal adhesions.

Area of Science:

  • Regenerative Medicine
  • Surgical Innovation
  • Biomaterials Science

Background:

  • Postoperative adhesions complicate intra-abdominal surgery, leading to significant hospital admissions.
  • Current prevention methods, like hyaluronate/carboxymethylcellulose, have limitations.
  • Human amniotic membrane possesses natural anti-inflammatory properties beneficial for adhesion mitigation.

Purpose of the Study:

  • To compare adhesion formation after surgical trauma using amniotic membranes versus standard intraperitoneal adhesion barriers.
  • To evaluate the efficacy of human amniotic membrane in preventing postoperative adhesions.

Main Methods:

  • A prospective, double-blinded study involving 40 male rats undergoing laparotomy with peritoneal disruption.
  • Random assignment to five groups: sham, control, saline, hyaluronic acid membrane, or amniotic membrane.
  • Adhesion assessment via gross and histological scoring (percentage of cecum involved, vascularity, strength, inflammation, fibrosis) and gene expression analysis at 14 days.

Main Results:

  • Amniotic membrane group showed significantly fewer adhesions (p=0.01) and lower cecal adhesion percentage (29%) compared to hyaluronic acid group (47%, p=0.04).
  • Histological analysis revealed no significant differences in inflammation or fibrosis between groups.
  • Genetic analysis indicated enhanced epithelialization and fibrosis inhibition with amniotic membranes.

Conclusions:

  • Human-derived amniotic membrane effectively reduces intraperitoneal adhesion formation post-surgical trauma.
  • Amniotic membranes demonstrate superiority over current antiadhesion barriers and exhibit good absorption and short-term safety.
  • Further research is warranted due to the study's preclinical nature and small sample size.
Abstract

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