title: Effect of the Mode of Application of Cryopreserved Human Amniotic Membrane on Adhesion Formation after Abdomino-Pelvic Surgery in a Mouse Model.
abstract: Adhesions after abdomino-pelvic surgery are a cause of morbidity and reoperations. The use of human amniotic membrane (HAM) for adhesion prevention has given controversial results. The mode of administration of the amniotic membrane has not been well studied. This study assessed the efficacy of two modes of application of cryopreserved HAM, patch or fragmented in Lactated Ringer (LR) solution, for the prevention of pelvic adhesion formation postabdomino-pelvic surgery in a mice model. After a midline laparotomy incision, a small cautery lesion was done on each side of the abdominal wall peritoneum in mice. In Group A (control; n = 42), the abdomen was closed directly, Group B (n = 42) received 2.5 ml of LR prior to closure. In Groups C (n = 42) and D (n = 42), a 2 cm × 2 cm patch of HAM and another one fragmented and dispersed in 2.5 ml of LR were applied prior to closure, respectively. Two weeks later, a laparotomy was performed, and gross and pathological evaluation of adhesions, fibrosis, angiogenesis, and inflammation were conducted. Group D exhibited a significantly lower rate of gross adhesion formation. Fibrosis was significantly lowest in Group C as compared to the control. Group B had the lowest vascular formation in the adhesions. The use of HAM fragmented in LR solution is associated with a significantly lower incidence of postoperative adhesions in mice when compared to LR alone, HAM patch, or control. The mechanism of action of this reduction needs to be elucidated by future studies.
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Joseph
authors.initials: J
authors.lastname: Nassif
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Sehrish A
authors.initials: SA
authors.lastname: Abbasi
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Mohamad Karim
authors.initials: MK
authors.lastname: Kechli
authors.affiliation: Department of Anatomy, Cell Biology and Physiology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Suzan S
authors.initials: SS
authors.lastname: Boutary
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Labib
authors.initials: L
authors.lastname: Ghulmiyyah
authors.affiliation: Department of Pathology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Khalifeh
authors.affiliation: Department of Internal Medicine, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Hussein
authors.initials: H
authors.lastname: Abou Ghaddara
authors.affiliation: Department of Obstetrics and Gynecology, American University of Beirut Medical Center , Beirut , Lebanon.
authors.forename: Anwar H
authors.initials: AH
authors.lastname: Nassar
keywords: abdomino-pelvic surgery; adhesion; human amniotic membrane; lactated ringer; mouse model