The Effect of Dried Amnion Membrane Application in the Expression of Platelet Derived Growth Factors in the Healing Process of Stomach Stab Wound (Study on New Zealand Rabbit)

Abstract

Background: Management of penetrating abdominal trauma, especially those affecting the stomach, keeps developing. Although the technology in the field of surgery is getting more advanced, the risk of complications due to leakage is still common. A lot of research is being done to improve the tissue healing process, including a variety of surgical techniques and material uses. The amniotic membrane is a material that is widely used to help stimulate the healing process. The amniotic membrane contains growth factors, one of which is platelet-derived growth factor (PDGF). PDGF is a major player in the wound healing process.Purpose: To investigate the differences in PDGF levels in gastric rupture repair with dry amniotic membrane as a biological dressing compared to primary repair of gastric rupture without using dry amniotic membrane.Method: This research was an experimental analytical study, using 42 samples of rabbits which were grouped into 2 groups, namely the control and treatment groups. Stab wound of 2 cm by 0.5 cm wide with a depth entire gastric wall in gastric corpus was done and repaired with 4-6 interrupted suture using 5/0 polypropylene monofilament. In the control group, the wound was only sutured and the treatment group, dry amniotic membrane was applicated before suturing. The expression of PDGF was examined from the suture tissue on day-7.Result: Intensity score was obtained in the treatment group with the highest score of 2 with a sample of 11 (52.4%) as well as in the control group as many as 13 (61.9%) samples who had a score of 2. The extension score was obtained in the treatment group with the highest score of 1 with a total sample size of 10 (47.6%) while the control group had the highest score with a score of 0.5 as much as 14 (66.7%). After obtaining the PDGF intensity and extension values, then these two values are multiplied to get the PDGF expression. From the results of the comparison test using the Mann Whitney test, it was found that the difference in PDGF expression was significant between the treatment group and the control group with p = 0.008 (p <0.05). Conclusion:Applying dry amniotic membrane to the wound on the stomach will increase the expression of PDGF in the wound area.