The Effects of Partial and Total Amniotic Fluid Exclusion on Excisional Fetal Rabbit Wounds

Ledbetter, M. Stephen; Morykwas, Michael J.; Ditesheim, Jeffrey A.; Ark, W. D. Vander; Rosee, J. R. La; Argenta, Louis C.

doi:10.1097/00000637-199108000-00008

Cited by 14 publications

(6 citation statements)

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“…Notably absent were acute inflammation, increased fibroblast pro liferation, and increased collagen deposition, in contrast to previous reports. 10,15 I n the present study, there was an increased cell density at the wound base along with increased epithelial cell migration. The increased cell density seen in the covered wound group suggests that healing was proceeding by a process resembling regeneration rather than the adult reparative process of inflammation, fibroplasia, collagen deposition, and wound WOUND REPAIR AND REGENERATION VOL.…”

Section: Discussionsupporting

confidence: 51%

Exposure to amniotic fluid inhibits closure of open wounds in the fetal rabbit

Haynes

Mast

Krummel

et al. 1995

Wound Repair Regeneration

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In many species, open cutaneous fetal wounds do not heal in utero. Such open wounds have been shown to close only after their exclusion from amniotic fluid, thus leading to the hypothesis that amniotic fluid inhibits open wound healing. Therefore the effect of amniotic fluid exposure on the healing of open fetal skin wounds was studied. Fetuses of New Zealand White rabbits received a full-thickness circular 4 mm diameter skin punch biopsy wound. Wounds were left uncovered, covered with a latex patch, or covered with a latex patch with a central hole (doughnut). This third group provided for wound exposure to amniotic fluid while controlling for any wound splinting effect of the patch. Wounds were harvested after 5 days, the wound area was determined planimetrically, and wound edges were examined by means of light microscopy. Analysis of glycosaminoglycans in the wound extra-cellular matrix was performed on a separate group of wounds treated similarly. Uncovered wounds enlarged by an average of 60%, whereas wounds covered with the doughnut patch enlarged by an average of 24%. In contrast, the wounds in the patch-covered group decreased in size by an average of 84%. Histologically all groups contained proliferating fibroblasts and epithelial migration at the wound edge but also an absence of granulation tissue. The patch-covered wounds, which had decreased wound area, were significantly enriched in hyaluronic acid. These results suggest that the healing of the patch-covered wounds occurs without the formation of granulation tissue, presumably through a process of cellular migration and proliferation and that healing was inhibited by exposure to amniotic fluid. Hyaluronic acid has been shown to be permissive of cellular migration and to play a key role in tissue regeneration. Therefore, we speculate that direct exposure of open wounds to amniotic fluid during the late stages of fetal development in the rabbit prevents hyaluronic acid deposition, which in turn may alter wound closure.

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Section: Discussionsupporting

confidence: 51%

Exposure to amniotic fluid inhibits closure of open wounds in the fetal rabbit

Haynes

Mast

Krummel

et al. 1995

Wound Repair Regeneration

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“…Provided that healing was being studied at a sufficiently early stage of the gestation period, investigators observed lack of contraction of untreated, excisional skin wounds in the rabbit; instead, significant wound expansion was documented in three rabbit studies (Ledbetter et al 1991;Lanning et al 1999Lanning et al , 2000. At sufficiently late stages of the gestation period, or following appropriate manipulation, investigators reported healing with contraction in excisional skin wounds in the foetal rabbit (Lanning et al 1999(Lanning et al , 2000 and foetal lamb models (Longaker et al 1991a,b;Horne et al 1992;Stelnicki et al 2000).…”

Section: Two Current Views Of the Ontogenetic Transition From Scarlesmentioning

confidence: 99%

Similarities and differences between induced organ regeneration in adults and early foetal regeneration

Yannas

2005

J. R. Soc. Interface.

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At least three organs (skin, peripheral nerves and the conjunctiva) have been induced to regenerate partially in adults following application of porous, degradable scaffolds with highly specific structure (templates). Templates blocked contraction and scar formation by inducing a reduction in the density of contractile fibroblasts (probably myofibroblasts) and by preventing these cells to organize themselves appropriately in the wound. In contrast, during early foetal healing, myofibroblasts were absent and wounds did not close by contraction but rather by spontaneous regeneration. The adult regenerative process has so far led to imperfect recovery of the physiological anatomy of skin (skin appendages were missing), while early foetal healing has led to apparently complete restoration. Furthermore, the mechanism of the adult regenerative process involves thwarting of myofibroblast function while, during early foetal healing, differentiation of myofibroblasts has not yet occurred. The data suggest that induced organ regeneration in the adult is the result of partial reversion to early foetal healing. If so, the adult may conceal a foetal response that may be subject to activation following application of highly active scaffolds or of other substances or cells.

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“…Sutured incisional fetal wounds heal with no visible scar formation, Presented in part at the American Society of Plastic and Reconstructive Surgeons Annual Meeting, Seattle, Washington, September 22-26, 1991. while excisional fetal rabbit wounds exposed to amniotic fluid apparently do not heal, displaying no inflammation, contraction, or reepithelialization (1)(2)(3)(4)(5)(6). However, coverage of fetal rabbit excisional wounds with an impermeable membrane that excludes amniotic fluid does allow a cellular inflammatory response, wound contraction, and reepithelialization (7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Arachidonic acid metabolites: Effects on inflammation of fetal rabbit excisional wounds

et al. 1992

Inflammation

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Uncovered fetal rabbit excisional wounds do not exhibit any classic signs of healing; wounds covered with an impermeable cover do contract, reepithelialize, and exhibit inflammation. Prostaglandin E2 (PGE2) is elevated in amniotic fluid, acting as an immunosuppressant at the maternal-fetal interface. Full-thickness excisional wounds were made on 25-day gestational age rabbit fetuses. Half the wounds were covered with an impermeable cover. Tissue from covered, uncovered, and nonwounded fetuses was examined 72 h after wounding for arachidonic acid metabolites. Uncovered wounds had significantly (P less than or equal to 0.05) elevated levels of PGE2, PGF2 alpha, and 12-HETE versus covered wounds and control tissue. Covered wounds had significantly elevated levels of 15-HETE compared to uncovered and control tissue. The elevated PGE2 in uncovered wounds may act as a fetal immunosuppressant; covered wounds (lower PGE2) developed cellular inflammation. Further investigations of these interactions may permit modulation of adult inflammation.

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The Effects of Partial and Total Amniotic Fluid Exclusion on Excisional Fetal Rabbit Wounds

Cited by 14 publications

References 0 publications

Exposure to amniotic fluid inhibits closure of open wounds in the fetal rabbit

Exposure to amniotic fluid inhibits closure of open wounds in the fetal rabbit

Similarities and differences between induced organ regeneration in adults and early foetal regeneration

Arachidonic acid metabolites: Effects on inflammation of fetal rabbit excisional wounds

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