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Markel JE, Franke JD, Woodberry KM, Fahrenkopf MP. Recent Updates on the Management of Split-thickness Skin Graft Donor Sites. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2024; 12:e6174. [PMID: 39296609 PMCID: PMC11410325 DOI: 10.1097/gox.0000000000006174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 07/24/2024] [Indexed: 09/21/2024]
Abstract
Background This article is a narrative review of split-thickness skin graft donor site (STSG-DS) management since the international guidelines were created in 2018. Although many new interventions have been developed, there is a lack of quality, multicentered clinical trials to produce updated evidence-based recommendations. Methods Electronic databases, including Google Scholar, Web of Science, Medline, and PubMed, were searched by two independent researchers for literature regarding STSG-DS management published from 2018 through 2022, using specific terms in the text, title, and abstract. The primary endpoint assessed was STSG-DS healing, as measured by wound epithelialization. Results Thirty-one articles were selected, including three systemic review/meta-analyses, five case series, 14 randomized controlled clinical trials, six observational studies, and three nonrandomized trials. Novel interventions for STSG-DS management included in this article describe applications of human amniotic membranes, acellular dermal matrices, cell suspensions and growth factors, biomaterials, electromagnetic radiation, and natural products. Conclusion Various interventions have shown promise for STSG-DS management since the creation of the 2018 international guidelines; however, studies with more standardized protocols and endpoints are needed to produce up-to-date, evidence-based recommendations and improve outcomes for patients undergoing split-thickness skin grafting.
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Affiliation(s)
- Justin E Markel
- From the Department of Internal Medicine, Cedars-Sinai Medical Center, West Hollywood, Calif
| | - Jacob D Franke
- Department of Plastic and Reconstructive Surgery, Corewell Health-Michigan State University College of Human Medicine, Grand Rapids, Mich
| | - Kerri M Woodberry
- Department of Plastic, Reconstructive, and Hand Surgery, West Virginia University, Grand Rapids, Mich
| | - Matthew P Fahrenkopf
- Department of Plastic and Reconstructive Surgery, Elite Plastic Surgery, Grand Rapids, Michigan
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2
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Kondej K, Zawrzykraj M, Czerwiec K, Deptuła M, Tymińska A, Pikuła M. Bioengineering Skin Substitutes for Wound Management-Perspectives and Challenges. Int J Mol Sci 2024; 25:3702. [PMID: 38612513 PMCID: PMC11011330 DOI: 10.3390/ijms25073702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/14/2024] Open
Abstract
Non-healing wounds and skin losses constitute significant challenges for modern medicine and pharmacology. Conventional methods of wound treatment are effective in basic healthcare; however, they are insufficient in managing chronic wound and large skin defects, so novel, alternative methods of therapy are sought. Among the potentially innovative procedures, the use of skin substitutes may be a promising therapeutic method. Skin substitutes are a heterogeneous group of materials that are used to heal and close wounds and temporarily or permanently fulfill the functions of the skin. Classification can be based on the structure or type (biological and synthetic). Simple constructs (class I) have been widely researched over the years, and can be used in burns and ulcers. More complex substitutes (class II and III) are still studied, but these may be utilized in patients with deep skin defects. In addition, 3D bioprinting is a rapidly developing method used to create advanced skin constructs and their appendages. The aforementioned therapies represent an opportunity for treating patients with diabetic foot ulcers or deep skin burns. Despite these significant developments, further clinical trials are needed to allow the use skin substitutes in the personalized treatment of chronic wounds.
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Affiliation(s)
- Karolina Kondej
- Department of Plastic Surgery, Medical University of Gdansk, 80-214 Gdansk, Poland;
| | - Małgorzata Zawrzykraj
- Department of Clinical Anatomy, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.Z.); (K.C.)
| | - Katarzyna Czerwiec
- Department of Clinical Anatomy, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.Z.); (K.C.)
| | - Milena Deptuła
- Laboratory of Tissue Engineering and Regenerative Medicine, Department of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (A.T.)
| | - Agata Tymińska
- Laboratory of Tissue Engineering and Regenerative Medicine, Department of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (A.T.)
| | - Michał Pikuła
- Laboratory of Tissue Engineering and Regenerative Medicine, Department of Embryology, Medical University of Gdansk, 80-211 Gdansk, Poland; (M.D.); (A.T.)
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Pfister P, Wendel-Garcia PD, Meneau I, Vasella M, Watson JA, Bühler P, Rittirsch D, Lindenblatt N, Kim BS. Human amniotic membranes as an allogenic biological dressing for the treatment of burn wounds: Protocol for a randomized-controlled study. Contemp Clin Trials Commun 2023; 36:101209. [PMID: 37753391 PMCID: PMC10518583 DOI: 10.1016/j.conctc.2023.101209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/02/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
Background Burn wounds pose significant challenges in medical treatment due to their devastating nature and resource-intensive requirements. Temporary coverage of burn wounds using synthetic or biological dressings allows for reepithelization before definitive skin grafting. Allogenic skin grafts have been widely used but come with drawbacks such as rejection and disease transmission. The use of amniotic membranes (AMs) offers a promising alternative for temporary coverage, as they possess biological properties that promote faster healing and improved scar quality. The various components of the amniotic membrane, including pluripotent stem cells, extracellular matrix proteins, and regenerative factors, contribute to cell growth, migration, and differentiation, as well as preservation of the original epithelial phenotype. Objective Reliable information on the treatment of burn wounds with AM is needed. The knowledge gained in this project may help to include this advantageous modern concept of biological dressings in clinical practice. The purpose of this study is to use human amniotic membranes from our in hospital laboratory, as an allogenic biological dressing after enzymatic debridement in superficial partial thickness, deep partial thickness or full thickness burn wounds. Methods We will include 30 patients in a randomized-controlled trial with each patient receiving the study intervention and the control intervention. Two 7 × 7 cm burn wound areas will be compared regarding percentage of skin graft take, healing time, healing percentage value and total healing time. Human amniotic membranes will be compared to allogenic skin grafts.
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Affiliation(s)
- Pablo Pfister
- Department of Intensive Care, Burn Center, University Hospital Zurich, Zurich, Switzerland
| | | | - Isabelle Meneau
- Department of Ophtalmology, Eye Bank Laboratory, University Hospital Zurich, Zurich, Switzerland
| | - Mauro Vasella
- Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zurich, Zurich, Switzerland
| | - Jennifer Ashley Watson
- Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zurich, Zurich, Switzerland
| | - Philipp Bühler
- Department of Intensive Care, Burn Center, University Hospital Zurich, Zurich, Switzerland
- Department of Intensive Care, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Daniel Rittirsch
- Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zurich, Zurich, Switzerland
| | - Nicole Lindenblatt
- Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zurich, Zurich, Switzerland
| | - Bong-Sung Kim
- Department of Plastic Surgery and Hand Surgery, Burn Center, University Hospital Zurich, Zurich, Switzerland
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4
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Babot-Pereña N, Blanco-Blanco J. Healing techniques for split-thickness skin grafts donor sites. Umbrella review. ENFERMERIA CLINICA (ENGLISH EDITION) 2023; 33:432-437. [PMID: 37898169 DOI: 10.1016/j.enfcle.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 10/09/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVES To summarize the existing evidence and provide recommendations for the most effective management of partial-thickness graft donor sites in adults, with the goals of enhancing re-epithelialization, reducing pain, and preventing infection. METHODOLOGY Umbrella review. A systematic search was conducted encompassing databases such as Pubmed, CUIDEN, Cochrane Library, CINHAL Plus, SCOPUS, and LILACS. The search targeted systematic reviews published since 2011 that focused on examining the effectiveness of different approaches for the treatment of partial-thickness graft donor sites. Reviews with a low critical appraisal score according to AMSTAR 2 were excluded. The included reviews were evaluated using the SIGN scale to assess the level of evidence and grade the recommendations. RESULTS Five systematic reviews with meta-analysis were incorporated in the analysis. Platelet-rich plasma and human amniotic membrane demonstrated statistically significant improvements in re-epithelialization and pain reduction when compared to the control group. Moreover, platelet-rich plasma also exhibited a decrease in wound infection rates. Recombinant human growth hormone was found to expedite the re-epithelialization process. CONCLUSIONS Based on the findings, the use of platelet-rich plasma is recommended to enhance re-epithelialization, alleviate pain, and reduce infection in partial-thickness graft donor sites among adults. Application of human amniotic membrane is recommended to accelerate re-epithelialization and alleviate pain, while recombinant human growth hormone is suggested to expedite the overall healing time of these wounds.
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Affiliation(s)
| | - Joan Blanco-Blanco
- Facultad de Enfermería y Fisioterapia, Universidad de Lleida, Lleida, Spain; Grupo de Estudios Sociedad, Salud, Educación y Cultura (GESEC), Universidad de Lleida, Lleida, Spain; Grupo de Investigación de Curas en Salud (GReCS), Instituto de Investigación Biomédica de Lleida-IRB Lleida, Universidad de Lleida, Lleida, Spain; CIBER de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
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5
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Hu Z, Luo Y, Ni R, Hu Y, Yang F, Du T, Zhu Y. Biological importance of human amniotic membrane in tissue engineering and regenerative medicine. Mater Today Bio 2023; 22:100790. [PMID: 37711653 PMCID: PMC10498009 DOI: 10.1016/j.mtbio.2023.100790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 08/21/2023] [Accepted: 08/31/2023] [Indexed: 09/16/2023] Open
Abstract
The human amniotic membrane (hAM) is the innermost layer of the placenta. Its distinctive structure and the biological and physical characteristics make it a highly biocompatible material in a variety of regenerative medicine applications. It also acts as a supply of bioactive factors and cells, which indicate the advantages over other tissues. In this review, we firstly discussed the biological properties of hAM-derived cells in vivo or in vitro, along with their stemness of markers, pointing out a promising source of stem cells for regenerative medicine. Then, we systematically summarized current knowledge on the collection, preparation, preservation, and decellularization of hAM, as well as their characteristics helping to improve the understanding of applications in tissue engineering. Finally, we highlighted the recent advances in which hAM has undergone additional modifications to achieve an adequate perspective of regenerative medicine applications. More investigations are required in utilizing appropriate modifications to enhance the therapeutic effectiveness of hAM in the future.
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Affiliation(s)
- Zeming Hu
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Yang Luo
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Renhao Ni
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Yiwei Hu
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Fang Yang
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Tianyu Du
- Health Science Center, Ningbo University, Ningbo, 315211, China
| | - Yabin Zhu
- Health Science Center, Ningbo University, Ningbo, 315211, China
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6
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Barski D, Tsaur I, Boros M, Brune J, Otto T. Functional Recovery after the Application of Amniotic Tissues and Methylene Blue during Radical Prostatectomy-A Pilot Study. Biomedicines 2023; 11:2260. [PMID: 37626756 PMCID: PMC10452294 DOI: 10.3390/biomedicines11082260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/02/2023] [Accepted: 08/11/2023] [Indexed: 08/27/2023] Open
Abstract
Amniotic tissues and methylene blue (MB) provide the ability for neuroregeneration, and MB enables intraoperative neurostaining. We first combined the techniques to explore a neuroprotective effect on early functional outcomes in a retrospective proof-of-concept trial of 14 patients undergoing radical prostatectomy (RP). The patients were followed up at a median of 13 months, and the continence and potency rates were reported. Early recovery of continence was found after three months. No effect on potency was detected. The findings indicate the feasibility of this tissue-engineering strategy, and justify prospective comparative studies.
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Affiliation(s)
- Dimitri Barski
- Department of Urology, Rheinland Klinikum Neuss, 41464 Neuss, Germany;
| | - Igor Tsaur
- Department for Urology and Pediatric Urology, University Medical Center of Johannes Gutenberg, 55131 Mainz, Germany
| | - Mihaly Boros
- Institute of Surgical Research, University of Szeged, 6720 Szeged, Hungary
| | - Jan Brune
- DIZG—Deutsches Institut für Zell-und Gewebeersatz gGmbH, 12555 Berlin, Germany
| | - Thomas Otto
- Department of Urology, Rheinland Klinikum Neuss, 41464 Neuss, Germany;
- Medical School, University of Duisburg-Essen, 45147 Essen, Germany
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7
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Danciu BM, Oţelea MR, Marincaş MA, Niţescu M, Simionescu AA. Is Spontaneous Preterm Prelabor of Membrane Rupture Irreversible? A Review of Potentially Curative Approaches. Biomedicines 2023; 11:1900. [PMID: 37509539 PMCID: PMC10377155 DOI: 10.3390/biomedicines11071900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/30/2023] [Accepted: 07/03/2023] [Indexed: 07/30/2023] Open
Abstract
There is still no curative treatment for the spontaneous preterm prelabor rupture of membranes (sPPROM), the main cause of premature birth. Here, we summarize the most recent methods and materials used for sealing membranes after sPPROM. A literature search was conducted between 2013 and 2023 on reported newborns after membranes were sealed or on animal or tissue culture models. Fourteen studies describing the outcomes after using an amniopatch, an immunologic sealant, or a mechanical cervical adapter were included. According to these studies, an increase in the volume of amniotic fluid and the lack of chorioamnionitis demonstrate a favorable neonatal outcome, with a lower incidence of respiratory distress syndrome and early neonatal sepsis, even if sealing is not complete and stable. In vivo and in vitro models demonstrated that amniotic stem cells, in combination with amniocytes, can spontaneously repair small defects; because of the heterogenicity of the data, it is too early to draw a thoughtful conclusion. Future therapies should focus on materials and methods for sealing fetal membranes that are biocompatible, absorbable, available, easy to apply, and easily adherent to the fetal membrane.
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Affiliation(s)
- Bianca Mihaela Danciu
- Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Obstetrics, Gynecology and Neonatology, "Dr. Alfred Rusescu" National Institute for Maternal and Child Health, 127715 Bucharest, Romania
| | - Marina Ruxandra Oţelea
- Clinical Department 5, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Marian Augustin Marincaş
- First Department of Surgery, Bucharest Oncological Institute Prof. Dr. Alexandru Trestioreanu, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania
| | - Maria Niţescu
- Preclinical Department 3, Complementary Sciences, Carol Davila University of Medicine and Pharmacy, 020125 Bucharest, Romania
| | - Anca Angela Simionescu
- Department of Obstetrics and Gynecology, Filantropia Clinical Hospital, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
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8
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Xiao H, Chen X, Liu X, Wen G, Yu Y. Recent advances in decellularized biomaterials for wound healing. Mater Today Bio 2023; 19:100589. [PMID: 36880081 PMCID: PMC9984902 DOI: 10.1016/j.mtbio.2023.100589] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/07/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
The skin is one of the most essential organs in the human body, interacting with the external environment and shielding the body from diseases and excessive water loss. Thus, the loss of the integrity of large portions of the skin due to injury and illness may lead to significant disabilities and even death. Decellularized biomaterials derived from the extracellular matrix of tissues and organs are natural biomaterials with large quantities of bioactive macromolecules and peptides, which possess excellent physical structures and sophisticated biomolecules, and thus, promote wound healing and skin regeneration. Here, we highlighted the applications of decellularized materials in wound repair. First, the wound-healing process was reviewed. Second, we elucidated the mechanisms of several extracellular matrix constitutes in facilitating wound healing. Third, the major categories of decellularized materials in the treatment of cutaneous wounds in numerous preclinical models and over decades of clinical practice were elaborated. Finally, we discussed the current hurdles in the field and anticipated the future challenges and novel avenues for research on decellularized biomaterials-based wound treatment.
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Affiliation(s)
- Huimin Xiao
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, 201306, China
| | - Xin Chen
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, 201306, China
| | - Xuanzhe Liu
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
| | - Gen Wen
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,College of Fisheries and Life Science, Shanghai Ocean University, Shanghai, 201306, China
| | - Yaling Yu
- Department of Orthopedic Surgery, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China.,Institute of Microsurgery on Extremities, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200233, China
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9
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Ansari A, Denton KM, Lim R. Strategies for immortalisation of amnion-derived mesenchymal and epithelial cells. Cell Biol Int 2022; 46:1999-2008. [PMID: 35998259 DOI: 10.1002/cbin.11892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/10/2022] [Indexed: 01/10/2023]
Abstract
Mesenchymal (human amniotic mesenchymal stem cell [HAMSC]) and epithelial cells (human amnion epithelial cell [HAEC]) derived from human amniotic membranes possess characteristics of pluripotency. However, the pluripotency of HAMSC and HAEC are sustained only for a finite period. This in vitro cell growth can be extended by cell immortalisation. Many well-defined immortalisation systems have been used for artificially overexpressing genes such as human telomerase reverse transcriptase in HAMSC and HAEC leading to controlled and prolonged cell proliferation. In recent years, much progress has been made in our understanding of the cellular machinery that regulates the cell cycle when immortalised. This review summarises the current understanding of molecular mechanisms that contribute to cell immortalisation, the strategies that have been employed to immortalise amnion-derived cell types, and their likely applications in regenerative medicine.
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Affiliation(s)
- Aneesa Ansari
- Department of Physiology, Monash University, Clayton, Australia.,Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia
| | - Kate M Denton
- Department of Physiology, Monash University, Clayton, Australia.,Cardiovascular Disease Program, Monash Biomedicine Discovery Institute, Monash University, Clayton, Australia
| | - Rebecca Lim
- The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Australia.,Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
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10
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The Use of Quercetin to Improve the Antioxidant and Regenerative Properties of Frozen or Cryopreserved Human Amniotic Membrane. Antioxidants (Basel) 2022; 11:antiox11071250. [PMID: 35883741 PMCID: PMC9311548 DOI: 10.3390/antiox11071250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 06/14/2022] [Accepted: 06/23/2022] [Indexed: 12/10/2022] Open
Abstract
The biological properties of the human amniotic membrane (HAM) and its characteristic ability to be a reservoir of growth factors promoting wound healing make it an ideal biological dressing for the treatment of different clinical conditions, such as burns and non-healing wounds. However, the application of a preservation method on the HAM is required during banking to maintain biological tissue properties and to ensure the release overtime of protein content for its final clinical effectiveness after application on the wound bed. Although cryopreservation and freezing are methods widely used to maintain tissue properties, reactive oxygen species (ROS) are produced within tissue cellular components during their switching from frozen to thawed state. Consequently, these methods can lead to oxidative stress-induced cell injury, affecting tissue regenerative properties and its final clinical effectiveness. Taking advantage of the antioxidant activity of the natural compound quercetin, we used it to improve the antioxidant and regenerative properties of frozen or cryopreserved HAM tissues. In particular, we evaluated the oxidative damage (lipid peroxidation, malondialdehyde) as well as the regenerative/biological properties (bFGF growth factor release, wound healing closure, structure, and viability) of HAM tissue after its application. We identified the effectiveness of quercetin on both preservation methods to reduce oxidative damage, as well as its ability to enhance regenerative properties, while maintaining the unaltered structure and viability of HAM tissue. The use of quercetin described in this study appears able to counteract the side effects of cryopreservation and freezing methods related to oxidative stress, enhancing the regenerative properties of HAM. However, further investigations will need to be performed, starting from these promising results, to identify its beneficial effect when applied on burns or non-healing wounds.
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11
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Hasmad HN, Bt Hj Idrus R, Sulaiman N, Lokanathan Y. Electrospun Fiber-Coated Human Amniotic Membrane: A Potential Angioinductive Scaffold for Ischemic Tissue Repair. Int J Mol Sci 2022; 23:ijms23031743. [PMID: 35163664 PMCID: PMC8836161 DOI: 10.3390/ijms23031743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/24/2022] [Accepted: 01/27/2022] [Indexed: 12/10/2022] Open
Abstract
Cardiac patch implantation helps maximize the paracrine function of grafted cells and serves as a reservoir of soluble proangiogenic factors required for the neovascularization of infarcted hearts. We have previously fabricated a cardiac patch, EF-HAM, composed of a human amniotic membrane (HAM) coated with aligned PLGA electrospun fibers (EF). In this study, we aimed to evaluate the biocompatibility and angiogenic effects of EF-HAM scaffolds with varying fiber thicknesses on the paracrine behavior of skeletal muscle cells (SkM). Conditioned media (CM) obtained from SkM-seeded HAM and EF-HAM scaffolds were subjected to multiplex analysis of angiogenic factors and tested on HUVECs for endothelial cell viability, migration, and tube formation analyses. All three different groups of EF-HAM scaffolds demonstrated excellent biocompatibility with SkM. CM derived from SkM-seeded EF-HAM 7 min scaffolds contained significantly elevated levels of proangiogenic factors, including angiopoietin-1, IL-8, and VEGF-C compared to plain CM, which was obtained from SkM cultured on the plain surface. CM obtained from all SkM-seeded EF-HAM scaffolds significantly increased the viability of HUVECs compared to plain CM after five days of culture. However, only EF-HAM 7 min CM induced a higher migration capacity in HUVECs and formed a longer and more elaborate capillary-like network on Matrigel compared with plain CM. Surface roughness and wettability of EF-HAM 7 min scaffolds might have influenced the proportion of skeletal myoblasts and fibroblasts growing on the scaffolds and subsequently potentiated the angiogenic paracrine function of SkM. This study demonstrated the angioinductive properties of EF-HAM composite scaffold and its potential applications in the repair and regeneration of ischemic tissues.
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12
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Da LC, Huang YZ, Xie HQ, Zheng BH, Huang YC, Du SR. Membranous Extracellular Matrix-Based Scaffolds for Skin Wound Healing. Pharmaceutics 2021; 13:1796. [PMID: 34834211 PMCID: PMC8620109 DOI: 10.3390/pharmaceutics13111796] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 10/16/2021] [Accepted: 10/22/2021] [Indexed: 02/05/2023] Open
Abstract
Membranous extracellular matrix (ECM)-based scaffolds are one of the most promising biomaterials for skin wound healing, some of which, such as acellular dermal matrix, small intestinal submucosa, and amniotic membrane, have been clinically applied to treat chronic wounds with acceptable outcomes. Nevertheless, the wide clinical applications are always hindered by the poor mechanical properties, the uncontrollable degradation, and other factors after implantation. To highlight the feasible strategies to overcome the limitations, in this review, we first outline the current clinical use of traditional membranous ECM scaffolds for skin wound healing and briefly introduce the possible repair mechanisms; then, we discuss their potential limitations and further summarize recent advances in the scaffold modification and fabrication technologies that have been applied to engineer new ECM-based membranes. With the development of scaffold modification approaches, nanotechnology and material manufacturing techniques, various types of advanced ECM-based membranes have been reported in the literature. Importantly, they possess much better properties for skin wound healing, and would become promising candidates for future clinical translation.
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Affiliation(s)
- Lin-Cui Da
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China; (L.-C.D.); (B.-H.Z.)
| | - Yi-Zhou Huang
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu 610041, China;
| | - Hui-Qi Xie
- Laboratory of Stem Cell and Tissue Engineering, Orthopedic Research Institute, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu 610041, China;
| | - Bei-Hong Zheng
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China; (L.-C.D.); (B.-H.Z.)
| | - Yong-Can Huang
- Shenzhen Engineering Laboratory of Orthopaedic Regenerative Technologies, Department of Spine Surgery, Peking University Shenzhen Hospital, Shenzhen 518036, China;
| | - Sheng-Rong Du
- Center of Reproductive Medicine, Fujian Maternity and Child Health Hospital, Affiliated Hospital of Fujian Medical University, Fuzhou 350001, China; (L.-C.D.); (B.-H.Z.)
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13
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Yang C, Xiong AB, He XC, Ding XB, Tian XL, Li Y, Yan H. Efficacy and feasibility of amniotic membrane for the treatment of burn wounds: A meta-analysis. J Trauma Acute Care Surg 2021; 90:744-755. [PMID: 33284236 DOI: 10.1097/ta.0000000000003050] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Burns cause a huge economic burden to society, and the wounds can be very difficult to manage. Clinical experience suggests that amniotic membrane (AM) is an economical and effective biological dressing for burns. However, few systematic reviews or meta-analyses have been published on such use. We aimed to evaluate the role of AM dressings in burn wounds. METHODS A systematic search of the PubMed, Cochrane, Embase, and Web of Science databases was conducted in March 2020. The search was conducted to identify randomized control trials that compared selected features of AM with those of other dressings, such as silver sulfadiazine, polyurethane membrane, and honey. For skin-grafted wounds, we compared AM-covered skin grafts and traditional staple-fixed skin grafts. Outcomes of interest for the efficacy analysis included wound infection, pain, itching, scarring, and healing time. The number of adverse events in each treatment group, the rate of withdrawal because of adverse effects, the cost of treatment, and patient acceptability were assessed for the feasibility analysis. RESULTS Eleven randomized controlled trials with 816 participants total were identified in our review. Amniotic membrane treatment was more effective than conventional methods, silver sulfadiazine, and polyurethane membrane in treating burn wounds, but AM appears to be less effective than honey. No reports of AM-related disease transmission or adverse reactions were described in the included articles. CONCLUSION Amniotic membrane has beneficial effects in treating burn wounds; however, the evidence needs to be strengthened by further robust randomized controlled trials. LEVEL OF EVIDENCE Systematic Review/Meta-analysis, level III.
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Affiliation(s)
- Chao Yang
- From the Department of Plastic and Burn Surgery, Affiliated Hospital of Southwest Medical University, National Key Clinical Construction Specialty, Wound Repair and Regeneration Laboratory, Luzhou, Sichuan, China
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Dadkhah Tehrani F, Firouzeh A, Shabani I, Shabani A. A Review on Modifications of Amniotic Membrane for Biomedical Applications. Front Bioeng Biotechnol 2021; 8:606982. [PMID: 33520961 PMCID: PMC7839407 DOI: 10.3389/fbioe.2020.606982] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 11/25/2020] [Indexed: 12/18/2022] Open
Abstract
The amniotic membrane (AM) is the innermost layer of the fetal placenta, which surrounds and protects the fetus. Its unique structure, in addition to its physical and biological properties, makes it a useful substance in many applications related to regenerative medicine. The use of this fantastic substance with a century-old history has produced remarkable results in vivo, in vitro, and even in clinical studies. While the intact or preserved AM is widely used for these purposes, the addition of further modifications to AM can be considered as a relatively new subject in its applications. These modifications are applied to improve AM properties, ease of handling, and durability. Here, we will discuss the cases in which AM has undergone additional modifications besides the required processes for sterilization and preservation. In this article, we have categorized these modifications and discussed their applications and results.
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Affiliation(s)
- Fatemeh Dadkhah Tehrani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Arezoo Firouzeh
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Iman Shabani
- Cell Engineering and Bio-microsystems Laboratory, Biomedical Engineering Faculty, Amirkabir University of Technology, Tehran, Iran
| | - Azadeh Shabani
- Preventative Gynecology Research Center, Department of Gynecology and Obstetrics, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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