The use of amniotic membrane in the repair of duodenal wounds in Wistar rats

Luciano Rodrigues Schimidt,Edson José Cardoso,Monique Viana De Sousa,Luiz Augusto Back,Rogério Rodrigues Schimidt,Maria Beatriz Schiazawa,Armando José D'Acampora

doi:10.1590/s0102-86502010000100006

Luciano Rodrigues Schimidt, Edson José Cardoso + Show 5 more

Open Access

https://doi.org/10.1590/s0102-86502010000100006

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Abstract

In the search of a new material to repair duodenal wounds, a trial was conducted to assess the behavior of human amniotic membrane in the repair of the duodenal wall in rats. Fifty Wistar rats weighing between 250 and 350g, male, were submitted to duodenotomy and randomly distributed into two groups. Group A (n=8) had no treatment and was used as the control group. In Group B (n=42) the duodenal wound was treated with a patch of human amniotic membrane. All animals in Group A died. In Group B no changes were observed with regards to death or the formation of duodenal fistula. All animals presented peritoneal adherences in the region on the duodenal wall repair and intestinal obstruction was observed in two animals. Healing of the duodenal wall in the region of the patch took place progressively as the post-operatory period increased, with regeneration of the mucosa and of the smooth muscle layer. From the clinical standpoint, the amniotic membrane proved to be a biological tissue which served as a temporary seal and allowed the wound to heal by second-intention, with re-establishment of the duodenal wall structure.

Highlights

Abdominal trauma is the most frequent cause of duodenal wounds, varying between 3 to 5%1-4
In the interest to find a new material to be used in the restoration of the duodenal wall, the human amniotic membrane presents features which seem to allow its use as a bioprosthetic material
The amniotic membrane presents characteristics which one would hope to find in an ideal bioprosthesis: it is easy to obtain, has a low cost, little antigenic, has an anti-bacterial activity, can be stocked, allows epithelial growth when used in the digestive tube, and its nutrition through diffusion allows it to be used as a free graft[15]

Summary

Introduction

Abdominal trauma is the most frequent cause of duodenal wounds, varying between 3 to 5%1-4. The use of amniotic membrane in the repair of duodenal wounds in Wistar rats techniques in search of a better surgical outcome in duodenal repair surgery[1,3,4,10,11]. In the interest to find a new material to be used in the restoration of the duodenal wall, the human amniotic membrane presents features which seem to allow its use as a bioprosthetic material. It is easy to obtain and to store, has a low cost, nourishes itself through diffusion, has an angiogenic and a somewhat nonantigenic character, being relatively resistant to infection[10] Based on such data, we have decided to study the behavior of the human amniotic membrane in the restoration of the duodenal wall in rats. The duodenal wound was completed by bringing together the two puncture points, with microsurgical scissors, the interest being on all the layers of the loop, with exposure of the intestinal lumen (Figure 1)

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