Insights on the Human Amniotic Membrane in Clinical Practice with a Focus on the New Applications in Retinal Surgery

Tartaro, Ruggero; Caporossi, Tomaso; Virgili, Gianni; Barca, Francesco; Giansanti, Fabrizio; Rizzo, Stanislao

doi:10.1007/s40883-020-00190-y

Cited by 3 publications

(3 citation statements)

References 87 publications

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“…Historical concerns of amniotic allografts’ retrieval, preparation, and storage before surgery, with tissue-borne disease transmission is addressed by sterile preparation and dehydration. The product storage and transportability means that amniotic membranes has received renewed interest in its effectiveness in a range of clinical practises [ 13 ]. In regards to RALP, the dissection of NVBs off of the prostate requires precision and correlation of biopsy histopathology to gross anatomy for optimising degrees of NS [ 14 ].…”

Section: Discussionmentioning

confidence: 99%

Nerve spare robot assisted laparoscopic prostatectomy with amniotic membranes: medium term outcomes

et al. 2022

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Introduction dHACM is a source of factors including cytokines that allow anti-inflammatory and proliferative elements to be utilized for wound and ulcer management. We present our experience of using dHACM in a cohort of patients undergoing nerve-sparing (NS) robot-assisted laparoscopic prostatectomy (RALP). Our objective is to investigate the functional and oncological outcomes of NS after placing amniotic or dehydrated human amnion/chorion membrane (dHACM) on preserved neurovascular bundles (NVBs). From 2013 to 2019, our institution performed transperitoneal multi-port da Vinci robotic prostatectomy. The NVBs are spared by releasing their fascial planes posteriorly, followed by an anterior release of the plane at a similar level. Once the retrograde release of the NVB is performed then 599 patients underwent placement of dHACM graft (AmnioFix by MiMedx, Marietta, GA, USA). The graft was cut into two 4 × 1 cm pieces and laid over the NVB as a wrap. In order to inform the urological community of oncological and functional outcomes, we excluded patients with less than 12 months follow up ( n = 64), benign prostatic hyperplasia ( n = 5), and unilateral NS ( n = 1). 529 (88%) patients were included in this study who underwent a partial or full bilateral NS with dHACM. 529 patients were followed-up for a median (IQR) of 42 months (25–89). Demographics include median (IQR) age 57 years (52–62), median preoperative SHIM score of 24 (21–15), and AUASS of 5 (2–11). Full NS was performed in 74% (391/529). Pathological staging was pT2 = 399 (75%), pT3a = 107 (20%), pT3b = 19 (4%) and pT4 = 4 (1%) with N1 = 3 (0.6%). The number of patients with PSM was 86 (16%), and the overall BCR in the entire cohort was 10%. Postoperatively, 434 (82%) were sexually active. Median time to potency was 119 (37–420) days and time to continence was 42 (23–91) days. Regarding full vs partial NS: median post op SHIM score 18 (13–20) vs 15 (6–20), median time to potency 92 (35–365) days vs 184 (42–560) days, and median time to continence 42 (23–91) days vs 44 (30–92) days. Age > 55 vs ≤ 55 years: median post op SHIM score 18 (12–20) vs 15 (10–20), median time to potency 167 days (42–549) vs 80 (35–288) days, and median time to continence 42 (25–116) days vs 42 (29–76) days. In our series the application of amniotic membrane/dHACM has led to acceptable post RALP outcomes. The BCR rate of 10% in addition to the recovery of potency at a median time of 3 months and continence at 6 weeks is an encouraging result of dHACM. Our findings indicate that dHACM allowed for an even faster period for continence recovery which was independent of grade of NS. Future comparative studies may further assess the impact of new amniotic membrane types on the functional and oncological outcomes after RALP.

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Section: Discussionmentioning

confidence: 99%

Nerve spare robot assisted laparoscopic prostatectomy with amniotic membranes: medium term outcomes

et al. 2022

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“…28,29 Based on these favorable characteristics of AM for tissue regeneration, several clinical trials of AM transplantation have been performed, and the results proved that AM was an excellent tool for repairing tissue with regenerative potential. [30][31][32][33][34] AM has already been used clinically in several ways, including the management of burns, creating a surgical dressing, reconstruction of the oral cavities and ocular surface, the bladder and vagina, tympanoplasty, and arthroplasty. 13,19,35,36 Currently, AM transplantation has become prevalent worldwide especially in ophthalmology for the treatment of corneal diseases such as perforating trauma, chemical/thermal injury, pterygium, Stevens-Johnson syndrome, pemphigoid, and keratitis.…”

Section: Discussionmentioning

confidence: 99%

“…Based on these favorable characteristics of AM for tissue regeneration, several clinical trials of AM transplantation have been performed, and the results proved that AM was an excellent tool for repairing tissue with regenerative potential 30–34 . AM has already been used clinically in several ways, including the management of burns, creating a surgical dressing, reconstruction of the oral cavities and ocular surface, the bladder and vagina, tympanoplasty, and arthroplasty 13,19,35,36 .…”

Section: Discussionmentioning

confidence: 99%

The Effects of Amniotic Membrane Transplantation on Vocal Fold Regeneration

et al. 2021

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Objectives/Hypothesis Vocal fold (VF) scar and sulcus cause severe vocal problems, but optimal methods have not been established. Total replacement of the mucosa is required particularly for cases in which the whole lamina propria is occupied by severe fibrosis and vibratory function is totally lost. The amniotic membrane (AM) has been proven to have regenerative potential, as it contains stem cells and growth factors. The current study investigated the biocompatibility and effects of AM for regeneration of the VF mucosa. Study Design In vitro and in vivo studies. Methods Vocal fold fibroblasts (VFFs) from 13 Sprague–Dawley rats were seeded on AM and subjected to histology and immunohistochemistry, and gene expressions in the VFFs on AM were examined in in vitro study. Twelve New Zealand White rabbits were used in in vivo study. VFs were stripped down and were reconstructed with AM. The regenerative effects were examined 3 months later by histological examination. Results In vitro study indicated VFFs survived on AM and stained positively for Ki67, vimentin, and fibronectin. Gene expressions of Has1, Has2, and Hgf were significantly increased in the VFFs on AM compared with the other groups. The in vivo study indicated AM‐transplanted VFs showed a significantly higher density of hyaluronic acid and lower density of collagen compared with sham VFs. Conclusions The current preliminary study suggests biocompatibility and possible regenerative effects of AM for VFs. Level of Evidence NA Laryngoscope, 132:2017–2025, 2022

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Treatment of recurrent high myopic macular hole associated with retinal detachment using a human amniotic membrane

et al. 2022

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Insights on the Human Amniotic Membrane in Clinical Practice with a Focus on the New Applications in Retinal Surgery

Cited by 3 publications

References 87 publications

Nerve spare robot assisted laparoscopic prostatectomy with amniotic membranes: medium term outcomes

Nerve spare robot assisted laparoscopic prostatectomy with amniotic membranes: medium term outcomes

The Effects of Amniotic Membrane Transplantation on Vocal Fold Regeneration

Treatment of recurrent high myopic macular hole associated with retinal detachment using a human amniotic membrane

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