title: Regeneration of peritoneum using amniotic membrane to prevent postoperative adhesions.
abstract: OBJECTIVE
  Adhesions following intraperitoneal surgery are frequent causes of small bowel obstruction. Attempts to prevent postoperative adhesions have mostly proven disappointing clinically. Currently used by ophthalmologists in ocular surface disorders, amniotic membrane transplantation can reduce inflammation and promote re-epithelization. We used amniotic membrane for facilitating peritoneal regeneration and prevention of adhesions with surgical trauma.
  
  
  METHODS
  20 rats were randomized in equal number into treatment or control groups. Seven days after operation, the incidence and severity of adhesions were evaluated. Histologic and immunohistochemical analyses were examined at 1, 4, 10 weeks after operation.
  
  
  RESULTS
  While severe adhesions were observed after 1 week between the cecum and surrounding organs in the control group, adhesion formation was significantly reduced in the amniotic membrane group. Histologic examination demonstrated that free-floating myofibroblasts in the peritoneal cavity attached to surfaces of amniotic membrane grafts to form a layered structure. Free-floating mesothelial cells were incorporated into the regenerating mesothelium on the myofibroblast layer in 4 weeks, while implanted amniotic membrane grafts were absorbed by 10 weeks. In the amniotic membrane group the cecum appeared nearly normal.
  
  
  CONCLUSIONS
  Amniotic membrane grafts reduced intraperitoneal adhesions after surgical trauma, were well absorbed, and served as a substrate for regenerating mesothelium.
authors.affiliation: Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kuriu
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Yamagishi
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakashima
authors.forename: Koji
authors.initials: K
authors.lastname: Miyagawa
authors.forename: Tetsuji
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Syuichi
authors.initials: S
authors.lastname: Kin
authors.forename: Yuen
authors.initials: Y
authors.lastname: Nakase
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Fukuda
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.forename: Chohei
authors.initials: C
authors.lastname: Sakakura
authors.forename: Junji
authors.initials: J
authors.lastname: Hamuro
authors.forename: Eiji
authors.initials: E
authors.lastname: Kurihara
authors.forename: Akeo
authors.initials: A
authors.lastname: Hagiwara
mesh_terms: D000650:Amnion / Q000637:transplantation*; D000818:Animals; D002432:Cecum / Q000601:surgery*; D008297:Male; D010529:Peritoneal Cavity / Q000601:surgery*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D012038:Regeneration; D000267:Tissue Adhesions / Q000517:prevention & control*