Effects of Acellular Amniotic Membrane Matrix and Bone Marrow-Derived Mesenchymal Stem Cells in Improving Random Skin Flap Survival in Rats.
BACKGROUND
The necrotic skin flap represents a great challenge in plastic and reconstructive surgery. In this study, we evaluated the effect of bioscaffolds, acellular amniotic membranes (AAMs), and bone marrow-derived mesenchymal stem cells (BM-MSCs) on random skin flap (RSF) survival in rats by applying a cell-free extracellular matrix scaffold as a supportive component for the growth and proliferation of BM-MSCs on RSFs. AAM matrix scaffolds were created by incubating AMs in ethylenediaminetetraacetic acid 0.05% at 37°C, and cell scrapers were used.


OBJECTIVE
The aim of the present study was to assess the effect of AAM as a scaffold in TE, and combined with transplanted BM-MSCs, on the survival of RSFs and on the biomechanical parameters of the incision-wound flap margins 7 days after flap elevation.


METHODS
BM-MSCs and AAMs were transplanted into subcutaneous tissue in the flap area. On the 7th postoperative day, the surviving flap areas were measured using digital imaging software, and the flap tissue was collected for evaluation. Forty rats were randomly divided into four groups of 10 each: group 1 received an AAM injection; group 2 underwent BM-MSC transplantation; group 3 received both AAM injection + BM-MSC transplantation; and group 4 was the control group, receiving only saline.


RESULTS
The survival area in the AAM/BM-MSC group was significantly higher than in the control group (18.49 ± 1.58 versus 7.51 ± 2.42, P < 0.05). The biomechanical assessment showed no significant differences between the experimental groups and the control group (P > 0.05), and there was no correlation with flap survival.


CONCLUSIONS
Our findings showed that the treatment of flaps with BM-MSC and AAM transplantations significantly promoted flap survival compared to a control group. The viability of the flap was improved by combining BM-MSCs with AAM matrix scaffolds.
Department of Anatomical Sciences, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, IR Iran.
Farzaneh
F
Chehelcheraghi
Department of Anatomical Sciences, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, IR Iran.
Hossein
H
Eimani
Department of Anatomical Sciences, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, IR Iran.
Seyed
S
Homayoonsadraie
Department of Physical Therapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran.
Giti
G
Torkaman
Department of Anatomy, Medical Faculty, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Abdollah
A
Amini
Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Hamid
H
Alavi Majd
Department of Speech Therapy, University of Welfare and Rehabilitation Sciences, Tehran, IR Iran.
Hashem
H
Shemshadi
Amnion; Bone Marrow; Mesenchymal Stromal Cells; Rats; Surgical Flaps