title: Effect of human amniotic fluid on bone healing.
abstract: BACKGROUND
  Bone healing continues to pose challenges for researchers and clinicians working in the field of plastic surgery. Complete bone regeneration cannot be obtained in critical size osseous defects without the application of osteogenic or osteoinductive bone material. In this study, we hypothesized that because extracellular matrix components are known to play a major role in the first steps of healing during bone or injury healing and because hyaluronic acid as chondroitin sulfate is recognized as an osteogenic compound without osteoinductive activity, human amniotic fluid, which contains high concentrations of hyaluronic acid, gyaluronic acid -stimulating activator, and other factors, might accelerate bone healing when applied subperiosteally to rabbit calvarial defects.
  
  
  METHODS
  We created 20 calvarial defects in 10 12-week-old New Zealand white rabbits who were divided into 2 groups. Group 1 defects were instilled with human amniotic fluid, whereas the group with contralateral defects, i.e., group 2, were given with same amount of normal saline solution. We then measured the density of the bone that formed over the defects using computed tomography at the third, fourth, fifth, and sixth weeks postoperatively. After this period, the defects were harvested for histopathologic evaluation.
  
  
  RESULTS
  The defects from group 1, which were treated with human amniotic fluid, showed significantly higher ossification than the group 2 defects, which were instilled with saline solution. Histological examination at 6 weeks postoperatively revealed that the defects treated with human amniotic fluid (group 1) had superior ossification compared with the control group defects (group 2).
  
  
  CONCLUSIONS
  Because of its positive effects on bone healing and also because of its ability to be stored in deep freeze if made cell-free, human amniotic fluid would appear to be a useful adjunct in the treatment of bone healing.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Karadeniz Technical University, Trabzon, Turkey. nkaracal@yahoo.com
authors.forename: Naci
authors.initials: N
authors.lastname: Karaçal
authors.forename: Polat
authors.initials: P
authors.lastname: Koşucu
authors.forename: Umit
authors.initials: U
authors.lastname: Cobanglu
authors.forename: Necmettin
authors.initials: N
authors.lastname: Kutlu
mesh_terms: D000653:Amniotic Fluid; D000818:Animals; D015519:Bone Density / Q000187:drug effects; D017102:Fracture Healing / Q000187:drug effects*; D006801:Humans; D006820:Hyaluronic Acid; D021621:Imaging, Three-Dimensional; D008297:Male; D010012:Osteogenesis / Q000187:drug effects*; D011817:Rabbits; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery*; D013518:Surgery, Plastic / Q000379:methods*
chemical_list: D006820:Hyaluronic Acid