title: Enhancing sealing of fetal membrane defects using tissue engineered native amniotic scaffolds in the rabbit model.
abstract: OBJECTIVE
  The purpose of this study was to compare the efficacy of native engineered amniotic scaffolds (AS) and polyesterurethane scaffolds (DegraPol) and document wound healing response when sealing iatrogenic fetal membrane defects in the rabbit model.
  
  
  METHODS
  Native AS were engineered from freshly harvested membranes of 23 days' gestational age (GA; term = 31-2 d). Acellularity of AS was assessed by histology, light and scanning electron microscopy. Fetal membrane defects were created by 14 gauge-needle puncture at GA 23 days and primarily closed with AS (n = 10) or DegraPol (n = 10) or left unclosed (positive controls; n = 10). Sixty-one sacs served as negative controls. At GA 30 days a second look hysterotomy was performed to assess presence of amniotic fluid (AF) and harvest plugging sites for microscopic evaluation.
  
  
  RESULTS
  Engineered AS had a cell-free collagenous fiber network. AF was significantly higher only in the DegraPol group (78%; P < .05) compared to the AF in positive controls (17%). Integration of plugs in the fetal membrane defect was better with AS than DegraPol, with higher reepithelialization rates (AS: 52.5% +/- 6.5%; DegraPol: 11.6% +/- 2.6%; P < .001) and proliferation indices (AS: 0.47 +/- 0.03; DegraPol: 0.28 +/- 0.04; P = .001). In both treatment groups, cell proliferation in the myometrium was increased (P < .05).
  
  
  CONCLUSIONS
  Native AS seal iatrogenic fetal membrane defects better than DegraPol. Within a week, there is abundant reepithelilization and minimal local inflammation. This yields the proof of principle that engineered native, amniotic membrane scaffolds enhance fetal membrane wound healing response.
authors.affiliation: Department of Obstetrics, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Ochsenbein-Kölble
authors.forename: Jacques
authors.initials: J
authors.lastname: Jani
authors.forename: Liesbeth
authors.initials: L
authors.lastname: Lewi
authors.forename: Godelieve
authors.initials: G
authors.lastname: Verbist
authors.forename: Lisbeth
authors.initials: L
authors.lastname: Vercruysse
authors.forename: Bettina
authors.initials: B
authors.lastname: Portmann-Lanz
authors.forename: Klaus
authors.initials: K
authors.lastname: Marquardt
authors.forename: Roland
authors.initials: R
authors.lastname: Zimmermann
authors.forename: Jan
authors.initials: J
authors.lastname: Deprest
mesh_terms: D000650:Amnion; D000818:Animals; D005321:Extraembryonic Membranes / Q000033:anatomy & histology / Q000293:injuries*; D023421:Models, Animal; D011091:Polyesters; D011140:Polyurethanes; D011817:Rabbits; D023822:Tissue Engineering / Q000379:methods*; D014945:Wound Healing
chemical_list: C104154:DegraPol; D011091:Polyesters; D011140:Polyurethanes