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Han WY, Han SJ, Kim EK, Han HH, Eom JS. A comparison of clinical outcomes of acellular dermal matrix with and without radiation sterilization process in immediate prepectoral direct-to-implant breast reconstruction. J Plast Reconstr Aesthet Surg 2023; 87:461-466. [PMID: 37944457 DOI: 10.1016/j.bjps.2023.10.087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 09/18/2023] [Accepted: 10/08/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Although there are many acellular dermal matrix (ADM) products, the sterilization process varies for each product. We compared the clinical outcomes of immediate prepectoral direct-to-implant (DTI) breast reconstruction with and without sterilization products. METHODS This was a retrospective study of immediate prepectoral DTI breast reconstructions performed between 2018 and 2020. We classified patients depending on whether the used ADM products had undergone radiation sterilization and compared the patient demographics and surgical outcomes, including seroma, infection, mastectomy flap necrosis, capsular contracture, and implant failure. RESULTS The study included 357 patients, 182 in the no-sterilization group and 179 in the sterilization group. The ADM size differed significantly between the no-sterilization and sterilization groups (122.7 cm2 vs. 145.4 cm2, respectively, P = 0.01). There were no significant differences in overall rates of complications between the two groups, including seroma (P = 0.28), infection (P = 0.63), mastectomy flap necrosis (P = 0.76), and capsular contracture (P = 0.76). However, implant failure from infection (0% vs. 3.4%, P = 0.01) and drainage amount (690.3 mL vs. 779.36 mL, P = 0.04) with similar removal days were significantly higher in the sterilization group. CONCLUSION The authors demonstrated similar complication rates for seroma, infection, mastectomy flap necrosis, and capsular contracture. Whereas a bigger size of ADM was needed to cover a similar implant volume, and drain amount was higher in the sterilization group, the salvage rate from infection was higher in the no-sterilization group with a significant difference.
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Affiliation(s)
- Woo Yeon Han
- Department of Plastic and Reconstructive Surgery, Yongin Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seong John Han
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eun Key Kim
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Hyun Ho Han
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jin Sup Eom
- Department of Plastic and Reconstructive Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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Ingraldi AL, Audet RG, Tabor AJ. The Preparation and Clinical Efficacy of Amnion-Derived Membranes: A Review. J Funct Biomater 2023; 14:531. [PMID: 37888195 PMCID: PMC10607219 DOI: 10.3390/jfb14100531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
Biological tissues from various anatomical sources have been utilized for tissue transplantation and have developed into an important source of extracellular scaffolding material for regenerative medicine applications. Tissue scaffolds ideally integrate with host tissue and provide a homeostatic environment for cellular infiltration, growth, differentiation, and tissue resolution. The human amniotic membrane is considered an important source of scaffolding material due to its 3D structural architecture and function and as a source of growth factors and cytokines. This tissue source has been widely studied and used in various areas of tissue repair including intraoral reconstruction, corneal repair, tendon repair, microvascular reconstruction, nerve procedures, burns, and chronic wound treatment. The production of amniotic membrane allografts has not been standardized, resulting in a wide array of amniotic membrane products, including single, dual, and tri-layered products, such as amnion, chorion, amnion-chorion, amnion-amnion, and amnion-chorion-amnion allografts. Since these allografts are not processed using the same methods, they do not necessarily produce the same clinical responses. The aim of this review is to highlight the properties of different human allograft membranes, present the different processing and preservation methods, and discuss their use in tissue engineering and regenerative applications.
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Affiliation(s)
- Alison L. Ingraldi
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Robert G. Audet
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
| | - Aaron J. Tabor
- Carmell Corporation, Pittsburg, PA 15203, USA;
- Department of Research and Development, Axolotl Biologix, Flagstaff, AZ 86001, USA
- Department of Biological Sciences, Northern Arizona University, Flagstaff, AZ 86011, USA
- Department of Clinical Operations, Axolotl Biologix, Flagstaff, AZ 86001, USA
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Lorenz K, Preem L, Sagor K, Putrinš M, Tenson T, Kogermann K. Development of In Vitro and Ex Vivo Biofilm Models for the Assessment of Antibacterial Fibrous Electrospun Wound Dressings. Mol Pharm 2023; 20:1230-1246. [PMID: 36669095 PMCID: PMC9907351 DOI: 10.1021/acs.molpharmaceut.2c00902] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/25/2022] [Accepted: 12/27/2022] [Indexed: 01/21/2023]
Abstract
Increasing evidence suggests that the chronicity of wounds is associated with the presence of bacterial biofilms. Therefore, novel wound care products are being developed, which can inhibit biofilm formation and/or treat already formed biofilms. A lack of standardized assays for the analysis of such novel antibacterial drug delivery systems enhances the need for appropriate tools and models for their characterization. Herein, we demonstrate that optimized and biorelevant in vitro and ex vivo wound infection and biofilm models offer a convenient approach for the testing of novel antibacterial wound dressings for their antibacterial and antibiofilm properties, allowing one to obtain qualitative and quantitative results. The in vitro model was developed using an electrospun (ES) thermally crosslinked gelatin-glucose (GEL-Glu) matrix and an ex vivo wound infection model using pig ear skin. Wound pathogens were used for colonization and biofilm development on the GEL-Glu matrix or pig skin with superficial burn wounds. The in vitro model allowed us to obtain more reproducible results compared with the ex vivo model, whereas the ex vivo model had the advantage that several pathogens preferred to form a biofilm on pig skin compared with the GEL-Glu matrix. The in vitro model functioned poorly for Staphylococcus epidermidis biofilm formation, but it worked well for Escherichia coli and Staphylococcus aureus, which were able to use the GEL-Glu matrix as a nutrient source and not only as a surface for biofilm growth. On the other hand, all tested pathogens were equally able to produce a biofilm on the surface of pig skin. The developed biofilm models enabled us to compare different ES dressings [pristine and chloramphenicol-loaded polycaprolactone (PCL) and PCL-poly(ethylene oxide) (PEO) (PCL/PEO) dressings] and understand their biofilm inhibition and treatment properties on various pathogens. Furthermore, we show that biofilms were formed on the wound surface as well as on a wound dressing, indicating that the demonstrated methods mimic well the in vivo situation. Colony forming unit (CFU) counting and live biofilm matrix as well as bacterial DNA staining together with microscopic imaging were performed for biofilm quantification and visualization, respectively. The results showed that both wound biofilm models (in vitro and ex vivo) enabled the evaluation of the desired antibiofilm properties, thus facilitating the design and development of more effective wound care products and screening of various formulations and active substances.
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Affiliation(s)
- Kairi Lorenz
- Institute
of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Liis Preem
- Institute
of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Kadi Sagor
- Institute
of Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Marta Putrinš
- Institute
of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
- Institute
of Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Tanel Tenson
- Institute
of Technology, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
| | - Karin Kogermann
- Institute
of Pharmacy, University of Tartu, Nooruse 1, 50411 Tartu, Estonia
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A Multicenter, Randomized, Controlled, Clinical Trial Evaluating Dehydrated Human Amniotic Membrane in the Treatment of Venous Leg Ulcers. Plast Reconstr Surg 2022; 150:1128-1136. [PMID: 36067479 PMCID: PMC9586828 DOI: 10.1097/prs.0000000000009650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND This randomized controlled trial evaluated the safety and effectiveness of weekly and biweekly applications of dehydrated human amnion and chorion allograft (dHACA) plus standard of care compared to standard of care alone on chronic venous leg ulcers. METHODS This open-label randomized controlled trial included patients with chronic venous leg ulcers at eight wound care centers across the United States. The primary endpoint was the proportion of healed ulcers at 12 weeks. Secondary endpoints included the proportion of ulcers achieving 40 percent closure at 4 weeks and the incidence of adverse events. RESULTS Among 101 patients screened for eligibility, 60 were eligible and enrolled. At 12 weeks, significantly more venous leg ulcers healed in the two dHACA-treated groups (75 percent) than in the standard-of-care group (30 percent) ( p = 0.001) even after adjustment for wound area ( p = 0.002), with an odds ratio of 8.7 (95 percent CI, 2.2 to 33.6). There were no significant differences in the proportion of wounds with percentage area reduction greater than or equal to 40 percent at 4 weeks among all groups. The adverse event rate was 63.5 percent. Among the 38 adverse events, none were graft or procedure related, and all were resolved with appropriate treatment. CONCLUSIONS dHACA and standard of care, either applied weekly or biweekly, significantly healed more venous leg ulcers than standard of care alone, suggesting that the use of aseptically processed dHACA is advantageous and a safe and effective treatment option in the healing of chronic venous leg ulcers. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, I.
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Impact of Gamma Irradiation on the Properties of Magnesium-Doped Hydroxyapatite in Chitosan Matrix. MATERIALS 2022; 15:ma15155372. [PMID: 35955308 PMCID: PMC9369862 DOI: 10.3390/ma15155372] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
This is the first report regarding the effect of gamma irradiation on chitosan-coated magnesium-doped hydroxyapatite (xMg = 0.1; 10 MgHApCh) layers prepared by the spin-coating process. The stability of the resulting 10 MgHApCh gel suspension used to obtain the layers has been shown by ultrasound measurements. The presence of magnesium and the effect of the irradiation process on the studied samples were shown by X-ray photoelectron spectroscopy (XPS). The XPS results obtained for irradiated 10 MgHApCh layers suggested that the magnesium and calcium contained in the surface layer are from tricalcium phosphate (TCP; Ca3(PO4)2) and hydroxyapatite (HAp). The XPS analysis has also highlighted that the amount of TCP in the surface layer increased with the irradiation dose. The energy-dispersive X-ray spectroscopy (EDX) evaluation showed that the calcium decreases with the increase in the irradiation dose. In addition, a decrease in crystallinity and crystallite size was highlighted after irradiation. By atomic force microscopy (AFM) we have obtained images suggesting a good homogeneity of the surface of the non-irradiated and irradiated layers. The AFM results were also sustained by the scanning electron microscopy (SEM) images obtained for the studied samples. The effect of gamma-ray doses on the Fourier transform infrared spectroscopy (ATR-FTIR) spectra of 10 MgHApCh composite layers was also evaluated. The in vitro antifungal assays proved that 10 MgHApCh composite layers presented a strong antifungal effect, correlated with the irradiation dose and incubation time. The study of the stability of the 10 MgHApCh gel allowed us to achieve uniform and homogeneous layers that could be used in different biomedical applications.
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Grémare A, Thibes L, Gluais M, Torres Y, Potart D, Da Silva N, Dusserre N, Fénelon M, Senthilhes L, Lacomme S, Svahn I, Gontier É, Fricain JC, L'Heureux N. Development of a vascular substitute produced by weaving yarn made from human amniotic membrane. Biofabrication 2022; 14. [PMID: 35896106 DOI: 10.1088/1758-5090/ac84ae] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 07/27/2022] [Indexed: 11/12/2022]
Abstract
Because synthetic vascular prostheses perform poorly in small-diameter revascularization, biological vascular substitutes are being developed as an alternative. Although their in vivo results are promising, their production involves long, complex, and expensive tissue engineering methods. To overcome these limitations, we propose an innovative approach that combines the human amniotic membrane (HAM), which is a widely available and cost-effective biological raw material, with a rapid and robust textile-inspired assembly strategy. Fetal membranes were collected after cesarean deliveries at term. Once isolated by dissection, HAM sheets were cut into ribbons that could be further processed by twisting into threads. Characterization of the HAM yarns (both ribbons and threads) showed that their physical and mechanical properties could be easily tuned. Since our clinical strategy will be to provide an off-the-shelf allogeneic implant, we studied the effects of decellularization and/or gamma sterilization on the histological, mechanical, and biological properties of HAM ribbons. Gamma irradiation of hydrated HAMs, with or without decellularization, did not interfere with the ability of the matrix to support endothelium formation in vitro. Finally, our HAM-based, woven tissue-engineered vascular grafts (TEVGs) exhibited clinically relevant mechanical properties. Thus, this study demonstrates that human, completely biological, allogeneic, small-diameter TEVGs can be produced from HAM, thereby avoiding costly cell culture and bioreactors.
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Affiliation(s)
- Agathe Grémare
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Lisa Thibes
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Maude Gluais
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Yoann Torres
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Diane Potart
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Nicolas Da Silva
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Nathalie Dusserre
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Mathilde Fénelon
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Loïc Senthilhes
- Obstetrics and Gynecology, CHU de Bordeaux, Hopital Pellegrin, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33076, FRANCE
| | - Sabrina Lacomme
- University of Bordeaux, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33000, FRANCE
| | - Isabelle Svahn
- University of Bordeaux, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33000, FRANCE
| | - Étienne Gontier
- University of Bordeaux, 146, Rue Léo Saignat, Bordeaux, Aquitaine, 33000, FRANCE
| | - Jean-Christophe Fricain
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
| | - Nicolas L'Heureux
- Heath Sciences and Technologies, University of Bordeaux, Campus Carreire, 146, Rue Léo Saignat, Bâtiment 4A, 2ième étage, Case 84, Bordeaux, Aquitaine, 33076, FRANCE
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Fernández Jiménez-Ortiz H, Sampedro Yañez R, Villarrubia Torcal B, Maroto Rodriguez B, Nava Pérez S, Monja N. Treatment and prevention of ocular motility restrictions with amniotic membrane transplantation. Strabismus 2021; 29:228-242. [PMID: 34686115 DOI: 10.1080/09273972.2021.1987925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We intend to investigate the indications, complications, and final results of amniotic membrane (AM) transplantation in ocular motility restrictions. Surgeons have tried to prevent restrictive adhesions between the extraocular muscles and surrounding tissues because they cause unpredictable results. AM transplantation wrapping extraocular musculature has been proposed as a technique with good results for this purpose. A search was carried out in Medline, Embase, Cochrane Library and Clinicaltrial, Lilac and Ibecs databases, using the indexed terms" amnion", "strabismus," "strabismus-subheading-surgery" and "ocular motility disorders." The only exclusion criteria were studies conducted in non-humans or studies with insufficient data on eye motility. No study was discarded for analysis because of language, age or methodology. This review includes 165 patients (223 eyes), with a mean follow-up of 11.49 months. The mean age was 21 years old, 47% were males and 57% were children. 14 studies conducted in humans were eligible: 4 single case, 8 case series, 1 cohort study and 1 randomized clinical trial. In the vast majority of these papers, use of AM transplantation to treat (12 out of 14 papers) or either to prevent (2 out of 14 papers) motility restrictions or restrictive strabismus secondary to muscular adhesions. All the studies except one presents very favorable results improving postsurgical eye motility. The cryopreservation method was more widely used, presenting a good safety profile with few adverse effects in the short and medium term. Significant improvement was reported in most patients after the use of amniotic membrane transplantation to treat or prevent ocular motility limitations. Very few complications or adverse effects were documented.
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Łabuś W, Kitala D, Klama-Baryła A, Szapski M, Kraut M, Smętek W, Glik J, Kucharzewski M, Rojczyk E, Utrata-Wesołek A, Trzebicka B, Szeluga U, Sobota M, Poloczek R, Kamiński A. Influence of electron beam irradiation on extracellular matrix of the human allogeneic skin grafts. J Biomed Mater Res B Appl Biomater 2021; 110:547-563. [PMID: 34478207 DOI: 10.1002/jbm.b.34934] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 06/29/2021] [Accepted: 08/22/2021] [Indexed: 12/14/2022]
Abstract
The nonviable allogeneic human skin grafts might be considered as the most suitable skin substitutes in the treatment of extensive and deep burns. However, in accordance to biological security such grafts require the final sterilization prior to clinical application. The aim of the study was to verify the influence of electron beam irradiation of three selected doses: 18, 25, and 35 kGy on the extracellular matrix of human skin. Prior to sterilization, the microbiological tests were conducted and revealed contamination in all examined cases. Individual groups were subjected to single electron beam radiation sterilization at proposed doses and then subjected to microbiological tests again. The results of microbiological testing performed for all irradiation doses used were negative. Only in the control group was a growth of microorganisms observed. The FTIR spectrometry tests were conducted followed by the histological evaluation and mechanical tests. In addition, cost analysis of radiation sterilization of individual doses was performed. The results of spectroscopic analysis, mechanical tests, and histological staining showed no significant changes in composition and characteristics of tested tissues after their irradiation, in comparison to control samples. The cost analysis has shown that irradiation with 18 kGy is the most cost-effective and 35 kGy is the least favorable. However, according to biological risk reduction, the recommended sterilization dose is 35 kGy, despite the higher price compared to the other doses tested.
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Affiliation(s)
- Wojciech Łabuś
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland
| | - Diana Kitala
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland
| | | | - Michał Szapski
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Gyncentrum, Laboratory of Molecular Biology and Virology, Katowice, Poland
| | - Małgorzata Kraut
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland
| | - Wojciech Smętek
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Warsaw University of Technology, Warsaw, Poland
| | - Justyna Glik
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Department of Chronic Wounds Healing Management Chronic Wound Care, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marek Kucharzewski
- Dr Stanisław Sakiel Center for Burns Treatment, Siemianowice Śląskie, Poland.,Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | - Ewa Rojczyk
- Department of Descriptive and Topographic Anatomy, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Zabrze, Poland
| | | | - Barbara Trzebicka
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Urszula Szeluga
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Michał Sobota
- Centre of Polymer and Carbon Materials, Polish Academy of Sciences, Zabrze, Poland
| | - Ryszard Poloczek
- Laboratory for Microscopic Examination "Diagno-Med", Siemianowice Slaskie, Poland
| | - Artur Kamiński
- Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, Warszawa, Poland.,National Centre for Tissue and Cell Banking, Warszawa, Poland
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The Influence of the Preservation Method and Gamma Irradiation Sterilization on TGF- β and bFGF Levels in Freeze-Dried Amnion Membrane (FD-AM) and Amnion Sponge. Int J Biomater 2021; 2021:6685225. [PMID: 33927767 PMCID: PMC8049824 DOI: 10.1155/2021/6685225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/18/2021] [Accepted: 03/30/2021] [Indexed: 11/17/2022] Open
Abstract
Background Amnion grafts can be preserved as freeze-dried amnion membrane (FD-AM) and amnion sponge. Preserved grafts require to be sterilized by gamma irradiation. However, each step of the process could affect its biological properties. Even so, there are only a few studies that report the influence of the preservation method and gamma irradiation on growth factor levels in preserved amniotic grafts. Methods This was an in vitro experimental study with a pretest-posttest group design using a consecutive sampling technique in one batch of amnion donors at a particular time. The amnion was made into FD-AM and amnion sponge preparations, and they were sterilized with gamma irradiation (15 kGy and 25 kGy). Nonirradiated specimens served as controls, and 20 mg of each specimen was pulverized to evaluate the growth factors levels using ELISA. Results There were significant decreases in amnion sponge compared to the FD-AM, both in transforming growth factor beta (TGF-β) and basic fibroblast growth factor (bFGF) levels and in the preirradiated and 25 kGy postirradiated preparations (p ≤ 0.05). The growth factor levels in the preirradiated and postirradiated FD-AM (both 15 kGy and 25 kGy) showed significant differences (p ≤ 0.05). Likewise, the preirradiated amnion sponge group's growth factor levels compared with the postirradiated amnion sponge group also showed a significant decrease (p ≤ 0.05). Conclusion TGF-β and bFGF levels were lower in amnion sponge than FD-AM. The FD-AM and amnion sponge preparations' growth factors levels were reduced following gamma irradiation sterilization. Although the decrease in growth factor levels is significant, the number of growth factor levels is still sufficient for tissue healing.
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10
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Paggiaro AO, Mathor MB, Teodoro WR, Isaac C, Capelozzi VL, Gemperli R. Evaluation of Radiosterilized Glyercerolated Amniotic Membranes as a Substrate for Cultured Human Epithelial Cells. Organogenesis 2020; 16:27-41. [PMID: 32063078 DOI: 10.1080/15476278.2020.1723366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Human amniotic membrane (HAM) is a biomaterial with biological properties beneficial to tissue repair, serving as a substrate for cell cultivation. Irradiation is used for tissue sterilization, but can damage the HAM structure. The objective of this paper was to construct a skin substitute, composed of human keratinocytes cultured on glycerolated HAMs, and to evaluate the influence radiation on subsequent cell culture growth. Four batches of HAMs were glycerolated, and half of them were radio-sterilzed with 25 kGy. Non-irradiated glycerolated HAM (ni-HAM) and irradiated glycerolated HAM (i-HAM) samples were then de-epithelized and analyzed using optical microscopy (Picrossirius staining), immunofluorescence and electron microscopy. Subsequently, keratinocytes were cultured on ni- and i-HAMs, and either immersed or positioned at the air-liquid interface. The basement membranes of the ni-HAM group remained intact following de-epithelialization, whereas the i-HAM group displayed no evidence or remnant presence of these membranes. Concerning the keratinocyte cultures, the ni-HAM substrate promoted the growth of multi-layered and differentiated epithelia. Keratinocytes cultured on i-HAM formed epithelium composed of three layers of stratification and discrete cell differentiation. The glycerolated HAM was compatible with cultured epithelia, demonstrating its potential as a skin substitute. Irradiation at 25 kGy caused structural damage to the amnion.
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Affiliation(s)
- André O Paggiaro
- Universidade de Guarulhos, Nursing Pós Graduation, Guarulhos, Brazil.,Universidade de São Paulo, Faculdade de Medicine, São Paulo, Brazil
| | - Monica B Mathor
- IPEN- Instituto de Pesquisa Energéticas e Nucleares, São Paulo, Brazil
| | - Walcy R Teodoro
- Universidade de São Paulo, Faculdade de Medicine, São Paulo, Brazil
| | - Cesár Isaac
- Universidade de São Paulo, Faculdade de Medicine, São Paulo, Brazil
| | - Vera L Capelozzi
- Universidade de São Paulo, Faculdade de Medicine, São Paulo, Brazil
| | - Rolf Gemperli
- Universidade de São Paulo, Faculdade de Medicine, São Paulo, Brazil
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11
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Gholipourmalekabadi M, Farhadihosseinabadi B, Faraji M, Nourani MR. How preparation and preservation procedures affect the properties of amniotic membrane? How safe are the procedures? Burns 2019; 46:1254-1271. [PMID: 31445711 DOI: 10.1016/j.burns.2019.07.005] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 05/14/2019] [Accepted: 07/03/2019] [Indexed: 12/22/2022]
Abstract
Human amniotic membrane (AM) has been widely used for tissue engineering and regenerative medicine applications. AM has many favorable characteristics such as high biocompatibility, antibacterial activity, anti-scarring property, immunomodulatory effects, anti-cancer behavior and contains several growth factors that make it an excellent natural candidate for wound healing. To date, various methods have been developed to prepare, preserve, cross-link and sterilize the AM. These methods remarkably affect the morphological, physico-chemical and biological properties of AM. Optimization of an effective and safe method for preparation and preservation of AM for a specific application is critical. In this review, the isolation, different methods of preparation, preservation, cross-linking and sterilization as well as their effects on properties of AM are well discussed. For each section, at least one effective and safe protocol is described in detail.
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Affiliation(s)
- Mazaher Gholipourmalekabadi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran; Department of Molecular Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medicine Sciences, Tehran, Iran
| | - Behrouz Farhadihosseinabadi
- Department of Biotechnology, School of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Faraji
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran; Department of Tissue Engineering & Regenerative Medicine, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Nourani
- Chemical Injuries Research Center, Systems Biology and Poisoning Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran; Nanobiotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
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12
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Meyer M. Processing of collagen based biomaterials and the resulting materials properties. Biomed Eng Online 2019; 18:24. [PMID: 30885217 PMCID: PMC6423854 DOI: 10.1186/s12938-019-0647-0] [Citation(s) in RCA: 235] [Impact Index Per Article: 47.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 03/12/2019] [Indexed: 02/07/2023] Open
Abstract
Collagen, the most abundant extracellular matrix protein in animal kingdom belongs to a family of fibrous proteins, which transfer load in tissues and which provide a highly biocompatible environment for cells. This high biocompatibility makes collagen a perfect biomaterial for implantable medical products and scaffolds for in vitro testing systems. To manufacture collagen based solutions, porous sponges, membranes and threads for surgical and dental purposes or cell culture matrices, collagen rich tissues as skin and tendon of mammals are intensively processed by physical and chemical means. Other tissues such as pericardium and intestine are more gently decellularized while maintaining their complex collagenous architectures. Tissue processing technologies are organized as a series of steps, which are combined in different ways to manufacture structurally versatile materials with varying properties in strength, stability against temperature and enzymatic degradation and cellular response. Complex structures are achieved by combined technologies. Different drying techniques are performed with sterilisation steps and the preparation of porous structures simultaneously. Chemical crosslinking is combined with casting steps as spinning, moulding or additive manufacturing techniques. Important progress is expected by using collagen based bio-inks, which can be formed into 3D structures and combined with live cells. This review will give an overview of the technological principles of processing collagen rich tissues down to collagen hydrolysates and the methods to rebuild differently shaped products. The effects of the processing steps on the final materials properties are discussed especially with regard to the thermal and the physical properties and the susceptibility to enzymatic degradation. These properties are key features for biological and clinical application, handling and metabolization.
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Affiliation(s)
- Michael Meyer
- Research Institute for Leather and Plastic Sheeting, Meissner Ring 1-5, 09599, Freiberg, Germany.
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13
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Abstract
PURPOSE Adhesions between the extraocular muscles and surrounding tissues pose a main cause of failure of strabismus reoperations. Amniotic membrane (AM) transplantation during extraocular muscle surgery, to prevent the formation of adhesions, has been a subject of research during the past decade. This review aims to determine the value, indications, and tips on usage of AM transplantation during strabismus surgery. MATERIALS AND METHODS All references cited in PubMed in English were searched using the key words: amniotic membrane strabismus or amniotic membrane extraocular muscles, and a brief summary of these was described. In addition, certain articles were chosen to provide introductory information on wound healing and fibrosis, AM properties and how it works after transplantation, and AM processing and preservation. RESULTS AM used for transplantation during extraocular muscle surgery may be cryopreserved, dried, or fresh. It may be oriented with its stroma or epithelium towards the muscle. It may or may not be fixed with sutures. What were the best choices? Various studies attempted to answer these questions. Many of the studies reviewed, however, were inconclusive or contradictory. Fresh AM seemed effective, but carried a risk of transmission of communicable diseases. Dried membrane was not of value in preventing adhesions. Histopathologically, cryopreserved membrane prevented the development of adhesions in the region of its presence, regardless of its orientation, and without the need for suture fixation. To accentuate this histopathological effect during clinical practice, it was recommended to utilize the largest segment possible of cryopreserved membrane and limit its usage to cases where adhesions are expected to be the main cause of failure of strabismus surgery. CONCLUSION Cryopreserved AM transplantation was safe and histopathologically effective in preventing adhesions. This effect was, however, less pronounced clinically. Its use during strabismus reoperations is merited if previous recommendations and precautions are considered.
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Dragúňová J, Kabát P, Cucorová V, Hajská M, Koller J. Deep frozen amniotic membrane used as a scaffold and/or carrier for different cell types. Cell Tissue Bank 2019; 20:35-48. [DOI: 10.1007/s10561-018-09747-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/30/2018] [Indexed: 01/22/2023]
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15
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Le Q, Deng SX. The application of human amniotic membrane in the surgical management of limbal stem cell deficiency. Ocul Surf 2019; 17:221-229. [PMID: 30633967 DOI: 10.1016/j.jtos.2019.01.003] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 11/12/2018] [Accepted: 01/07/2019] [Indexed: 12/31/2022]
Abstract
The application of human amniotic membrane (AM) has a wide spectrum of indications in the treatment of ocular surface disorders. Transplantation of AM has been incorporated routinely as a component of ocular surface reconstruction in a variety of ocular pathologies. The application of human AM can be combined with nearly all types of limbal transplantation in treating limbal stem cell deficiency (LSCD). AM provides support and possible protection to the transplanted limbal tissues and limbal stem cells owing to its mechanical and biological properties, and these properties are thought to enhance the success rate of LSC transplantation. This paper reviews the current literature on the applications of AM in the surgical management of LSCD and summarizes the outcome of different surgical approaches. The current literature contains mostly low-level evidences in supporting the role of AM. The efficacy of AM in LSC transplantation needs to be confirmed by randomized controlled clinical trials.
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Affiliation(s)
- Qihua Le
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, USA; Department of Ophthalmology, Eye & ENT Hospital of Fudan University, Shanghai 200031, China
| | - Sophie X Deng
- Stein Eye Institute, Cornea Division, David Geffen School of Medicine, University of California, Los Angeles, USA.
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Smeringaiova I, Nyc O, Trosan P, Spatenka J, Burkert J, Bednar J, Jirsova K. Antimicrobial efficiency and stability of two decontamination solutions. Cell Tissue Bank 2018; 19:581-589. [PMID: 30062597 DOI: 10.1007/s10561-018-9707-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 06/22/2018] [Indexed: 11/26/2022]
Abstract
Two decontamination solutions, commercially produced BASE•128 and laboratory decontamination solution (LDS), with analogous content of antibiotic and antimycotic agents, were compared in their antimicrobial efficiency and stability (pH and osmolarity). Both solutions were compared immediately after thawing aliquots frozen for 1, 3 or 6 months. Agar well diffusion method was used to test their antimicrobial efficiency against five human pathogens: Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis, Escherichia coli and Enterococcus faecalis. The difference in the inhibition of growth between the two decontamination solutions was mostly not statistically significant, with few exceptions. The most pronounced difference between the LDS and BASE•128 was observed in their decontamination efficacy against E. coli and E. faecalis, where the LDS showed to be more efficient than BASE•128. The osmolarity value of LDS decreased with cold-storage, the osmolarity values of the BASE•128 could not be measured as they were below the range of the osmometer. Slight changes were found in pH of the less stable LDS solution, whose pH increased from initial value 7.36 ± 0.07 to 7.72 ± 0.19 after 6 m-storage. We verified that BASE•128 and LDS are similarly efficient in elimination of possible placental bacterial contaminants and may be used for decontamination of various tissues.
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Affiliation(s)
- Ingrida Smeringaiova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Otakar Nyc
- Department of Clinical Microbiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Peter Trosan
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jaroslav Spatenka
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jan Burkert
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jan Bednar
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Katerina Jirsova
- Laboratory of the Biology and Pathology of the Eye, Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
- Laboratory of the Biology and Pathology of the Eye, Institute of Biology and Medical Genetics, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic.
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic.
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Delgado LM, Fuller K, Zeugolis DI. Influence of Cross-Linking Method and Disinfection/Sterilization Treatment on the Structural, Biophysical, Biochemical, and Biological Properties of Collagen-Based Devices. ACS Biomater Sci Eng 2018; 4:2739-2747. [DOI: 10.1021/acsbiomaterials.8b00052] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Luis M. Delgado
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
- Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Kieran Fuller
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
- Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
| | - Dimitrios I. Zeugolis
- Regenerative, Modular & Developmental Engineering Laboratory (REMODEL), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
- Science Foundation Ireland (SFI) Centre for Research in Medical Devices (CÚRAM), Biomedical Sciences Building, National University of Ireland Galway (NUI Galway), Galway, Ireland
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18
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Lee W, Toussaint KC. Quantitative analysis of the effect of environmental-scanning electron microscopy on collagenous tissues. Sci Rep 2018; 8:8491. [PMID: 29855602 PMCID: PMC5981445 DOI: 10.1038/s41598-018-26839-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/15/2018] [Indexed: 11/25/2022] Open
Abstract
Environmental-scanning electron microscopy (ESEM) is routinely applied to various biological samples due to its ability to maintain a wet environment while imaging; moreover, the technique obviates the need for sample coating. However, there is limited research carried out on electron-beam (e-beam) induced tissue damage resulting from using the ESEM. In this paper, we use quantitative second-harmonic generation (SHG) microscopy to examine the effects of e-beam exposure from the ESEM on collagenous tissue samples prepared as either fixed, frozen, wet or dehydrated. Quantitative SHG analysis of tissues, before and after ESEM e-beam exposure in low-vacuum mode, reveals evidence of cross-linking of collagen fibers, however there are no structural differences observed in fixed tissue. Meanwhile wet-mode ESEM appears to radically alter the structure from a regular fibrous arrangement to a more random fiber orientation. We also confirm that ESEM images of collagenous tissues show higher spatial resolution compared to SHG microscopy, but the relative tradeoff with collagen specificity reduces its effectiveness in quantifying collagen fiber organization. Our work provides insight on both the limitations of the ESEM for tissue imaging, and the potential opportunity to use as a complementary technique when imaging fine features in the non-collagenous regions of tissue samples.
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Affiliation(s)
- Woowon Lee
- University of Illinois at Urbana-Champaign, Department of Mechanical Science and Engineering, 1206 W Green Street, Urbana, Illinois, 61801, United States
- University of Illinois at Urbana-Champaign, PROBE Lab, 1206 W Green Street, Urbana, Illinois, 61801, United States
| | - Kimani C Toussaint
- University of Illinois at Urbana-Champaign, Department of Mechanical Science and Engineering, 1206 W Green Street, Urbana, Illinois, 61801, United States.
- University of Illinois at Urbana-Champaign, PROBE Lab, 1206 W Green Street, Urbana, Illinois, 61801, United States.
- University of Illinois at Urbana-Champaign, Affiliate in the Department of Electrical and Computer Engineering, 1406 W Green Street, Urbana, Illinois, 61801, United States.
- University of Illinois at Urbana-Champaign, Department of Bioengineering, 1270 Digital Computer Laboratory, Urbana, Illinois, 61801, United States.
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19
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Harrell CR, Djonov V, Fellabaum C, Volarevic V. Risks of Using Sterilization by Gamma Radiation: The Other Side of the Coin. Int J Med Sci 2018; 15:274-279. [PMID: 29483819 PMCID: PMC5820857 DOI: 10.7150/ijms.22644] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 12/21/2017] [Indexed: 12/30/2022] Open
Abstract
The standard sterilization method for most medical devices over the past 40 years involves gamma irradiation. During sterilization, gamma rays efficiently eliminate microorganisms from the medical devices and tissue allografts, but also significantly change molecular structure of irradiated products, particularly fragile biologics such as cytokines, chemokines and growth factors. Accordingly, gamma radiation significantly alters biomechanical properties of bone, tendon, tracheal, skin, amnion tissue grafts and micronized amniotic membrane injectable products. Similarly, when polymer medical devices are sterilized by gamma radiation, their physico-chemical characteristics undergo modification significantly affecting their clinical use. Several animal studies demonstrated that consummation of irradiated food provoked genome instability raising serious concerns regarding oncogenic potential of irradiated consumables. These findings strongly suggest that new, long-term, prospective clinical studies should be conducted in near future to investigate whether irradiated food is safe for human consumption. In this review, we summarized current knowledge regarding molecular mechanisms responsible for deleterious effects of gamma radiation with focusing on its significance for food safety and biomechanical characteristics of medical devices, and tissue allografts, especially injectable biologics.
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Affiliation(s)
- C Randall Harrell
- Regenerative Processing Plant, LLC, Palm Harbor, Florida, United States of America
| | | | - Crissy Fellabaum
- Regenerative Processing Plant, LLC, Palm Harbor, Florida, United States of America
| | - Vladislav Volarevic
- Department of Microbiology and Immunology, Center for Molecular Medicine and Stem Cell Research, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia
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20
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Phipps A, Vaynshteyn E, Kowalski JB, Ngo MD, Merritt K, Osborne J, Chnari E. Chemical sterilization of allograft dermal tissues. Cell Tissue Bank 2017; 18:573-584. [DOI: 10.1007/s10561-017-9647-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 07/27/2017] [Indexed: 12/12/2022]
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21
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Smeringaiova I, Trosan P, Mrstinova MB, Matecha J, Burkert J, Bednar J, Jirsova K. Comparison of impact of two decontamination solutions on the viability of the cells in human amnion. Cell Tissue Bank 2017; 18:413-423. [PMID: 28677080 DOI: 10.1007/s10561-017-9636-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 06/06/2017] [Indexed: 11/26/2022]
Abstract
Human amniotic membrane (HAM) is used as an allograft in regenerative medicine or as a source of pluripotent cells for stem cell research. Various decontamination protocols and solutions are used to sterilize HAM before its application, but little is known about the toxicity of disinfectants on HAM cells. In this study, we tested two decontamination solutions, commercial (BASE·128) and laboratory decontamination solution (LDS), with an analogous content of antimycotic/antibiotics for their cytotoxic effect on HAM epithelial (EC) and mesenchymal stromal cells (MSC). HAM was processed in a standard way, placed on nitrocellulose scaffold, and decontaminated, following three protocols: (1) 6 h, 37 °C; (2) 24 h, room temperature; (3) 24 h, 4 °C. The viability of EC was assessed via trypan blue staining. The apoptotic cells were detected using terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL). The mean % (±SD) of dead EC (%DEC) from six fresh placentas was 12.9 ± 18.1. Decontamination increased %DEC compared to culture medium. Decontamination with BASE·128 for 6 h, 37 °C led to the highest EC viability (81.7%). Treatment with LDS at 24 h, 4 °C resulted in the lowest EC viability (55.9%) in the set. MSC were more affected by apoptosis than EC. Although the BASE·128 expresses lower toxicity compared to LDS, we present LDS as an alternative decontamination solution with a satisfactory preservation of cell viability. The basic formula of LDS will be optimised by enrichment with nutrient components, such as glucose or vitamins, to improve cell viability.
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Affiliation(s)
- Ingrida Smeringaiova
- Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 2, 128 08, Prague, Czech Republic
| | - Peter Trosan
- Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 2, 128 08, Prague, Czech Republic
| | - Miluse Berka Mrstinova
- Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Matecha
- Department of Obstetrics and Gynaecology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Burkert
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic
| | - Jan Bednar
- Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 2, 128 08, Prague, Czech Republic
| | - Katerina Jirsova
- Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Ke Karlovu 2, 128 08, Prague, Czech Republic.
- Department of Transplantation and Tissue Bank, Motol University Hospital, Prague, Czech Republic.
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22
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Jirsova K, Jones GLA. Amniotic membrane in ophthalmology: properties, preparation, storage and indications for grafting-a review. Cell Tissue Bank 2017; 18:193-204. [PMID: 28255771 DOI: 10.1007/s10561-017-9618-5] [Citation(s) in RCA: 188] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 02/24/2017] [Indexed: 12/11/2022]
Abstract
The use of amniotic membrane in ophthalmic surgery and other surgical procedures in the fields of dermatology, plastic surgery, genitourinary medicine and otolaryngology is on the increase. Furthermore, amniotic membrane and its epithelial and mesenchymal cells have broad use in regenerative medicine and hold great promise in anticancer treatment. Amniotic membrane is a rich source of biologically active factors and as such, promotes healing and acts as an effective material for wound dressing. Amniotic membrane supports epithelialization and exhibits anti-fibrotic, anti-inflammatory, anti-angiogenic and anti-microbial features. Placentas utilised in the preparation of amniotic membrane are retrieved from donors undergoing elective caesarean section. Maternal blood must undergo serological screening at the time of donation and, in the absence of advanced diagnostic testing techniques, 6 months postpartum in order to cover the time window for the potential transmission of communicable diseases. Amniotic membrane is prepared by blunt dissection under strict aseptic conditions, then is typically transferred onto a nitrocellulose paper carrier, usually with the epithelial side up, and cut into multiple pieces of different dimensions. Amniotic membrane can be stored under various conditions, most often cryopreserved in glycerol or dimethyl sulfoxide or their mixture with culture medium or buffers. Other preservation methods include lyophilisation and air-drying. In ophthalmology, amniotic membrane is increasingly used for ocular surface reconstruction, including the treatment of persistent epithelial defects and non-healing corneal ulcers, corneal perforations and descemetoceles, bullous keratopathy, as well as corneal disorders with associated limbal stem cell deficiency, pterygium, conjunctival reconstruction, corneoscleral melts and perforations, and glaucoma surgeries.
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Affiliation(s)
- Katerina Jirsova
- Laboratory of the Biology and Pathology of the Eye, Institute of Inherited Metabolic Disorders, General Teaching Hospital and 1st Faculty of Medicine, Charles University, Czech Republic, Ke Karlovu 2, 128 08, Prague 2, Czech Republic.
| | - Gary L A Jones
- The Veneto Eye Bank Foundation, Padiglione Rama - Via Paccagnella n. 11, 30174, Zelarino, Venice, Italy
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Nilsen TJ, Dasgupta A, Huang YC, Wilson H, Chnari E. Do Processing Methods Make a Difference in Acellular Dermal Matrix Properties? Aesthet Surg J 2016; 36:S7-S22. [PMID: 27697888 DOI: 10.1093/asj/sjw163] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The use of acellular dermal matrices (ADMs) has become the standard of practice in many reconstructive and aesthetic surgical applications. Different methods used to prepare the allograft tissue for surgical use can alter the ADMs natural properties. Aseptic processing has been shown to retain the natural properties of ADMs more favorably than terminally sterilized ADMs. Terminal sterilization has been historically linked to alteration of biological materials. In vitro work was conducted to compare ADM processing methods. OBJECTIVES Characterize aseptically processed ADMs and compare cell-matrix interaction characteristics to terminally sterilized ADMs. METHODS Two aseptically processed ADMs, FlexHD Pliable and BellaDerm, were characterized via histological evaluation, biomechanical integrity, enzymatic degradation, and in vitro cell studies. FlexHD Pliable was compared to Alloderm Ready-to-Use (RTU). RESULTS Histological evaluation revealed that FlexHD Pliable had a uniform, open structure compared to BellaDerm. Mechanical characterization demonstrated that BellaDerm had higher strength and stiffness compared to FlexHD Pliable, which maintained higher elasticity. Immunohistochemical analysis verified that key matrix proteins remained intact after aseptic processing. Cell studies found that fibroblasts attached more readily, and proliferated faster on FlexHD Pliable compared to BellaDerm. Additionally, fibroblasts infiltrated into FlexHD Pliable from both sides and on the dermal side in BellaDerm and produced an abundance of multi-layered matrix proteins (collagen, fibronectin) when compared to AlloDerm RTU which was sparse. CONCLUSIONS Aseptically processed FlexHD Pliable and BellaDerm provide a suitable, biocompatible option for tissue repair and regeneration in aesthetic and reconstructive surgical applications.
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Affiliation(s)
- Todd J Nilsen
- Mr Nilsen is a Senior Engineer, Dr Dasgupta is a Senior Scientist, and Dr Chnari is an Associate Director, Research and Development, Wound Care, and General and Plastic Surgery; and Dr Huang is a Staff Scientist, Research and Development and Allograft Materials Research, Musculoskeletal Transplant Foundation, Edison, NJ. Dr Wilson is a Clinical Assistant Professor of Plastic Surgery, Liberty University College of Osteopathic Medicine, Lynchburg, VA
| | - Anouska Dasgupta
- Mr Nilsen is a Senior Engineer, Dr Dasgupta is a Senior Scientist, and Dr Chnari is an Associate Director, Research and Development, Wound Care, and General and Plastic Surgery; and Dr Huang is a Staff Scientist, Research and Development and Allograft Materials Research, Musculoskeletal Transplant Foundation, Edison, NJ. Dr Wilson is a Clinical Assistant Professor of Plastic Surgery, Liberty University College of Osteopathic Medicine, Lynchburg, VA
| | - Yen-Chen Huang
- Mr Nilsen is a Senior Engineer, Dr Dasgupta is a Senior Scientist, and Dr Chnari is an Associate Director, Research and Development, Wound Care, and General and Plastic Surgery; and Dr Huang is a Staff Scientist, Research and Development and Allograft Materials Research, Musculoskeletal Transplant Foundation, Edison, NJ. Dr Wilson is a Clinical Assistant Professor of Plastic Surgery, Liberty University College of Osteopathic Medicine, Lynchburg, VA
| | - Henry Wilson
- Mr Nilsen is a Senior Engineer, Dr Dasgupta is a Senior Scientist, and Dr Chnari is an Associate Director, Research and Development, Wound Care, and General and Plastic Surgery; and Dr Huang is a Staff Scientist, Research and Development and Allograft Materials Research, Musculoskeletal Transplant Foundation, Edison, NJ. Dr Wilson is a Clinical Assistant Professor of Plastic Surgery, Liberty University College of Osteopathic Medicine, Lynchburg, VA
| | - Evangelia Chnari
- Mr Nilsen is a Senior Engineer, Dr Dasgupta is a Senior Scientist, and Dr Chnari is an Associate Director, Research and Development, Wound Care, and General and Plastic Surgery; and Dr Huang is a Staff Scientist, Research and Development and Allograft Materials Research, Musculoskeletal Transplant Foundation, Edison, NJ. Dr Wilson is a Clinical Assistant Professor of Plastic Surgery, Liberty University College of Osteopathic Medicine, Lynchburg, VA
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DiDomenico LA, Orgill DP, Galiano RD, Serena TE, Carter MJ, Kaufman JP, Young NJ, Zelen CM. Aseptically Processed Placental Membrane Improves Healing of Diabetic Foot Ulcerations: Prospective, Randomized Clinical Trial. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2016; 4:e1095. [PMID: 27826487 PMCID: PMC5096542 DOI: 10.1097/gox.0000000000001095] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2016] [Accepted: 08/31/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Allogeneic grafts derived from amnion/chorion are known to be efficacious in healing chronic diabetic foot ulcerations (DFUs). The goal of this study was to compare aseptically processed dehydrated human amnion and chorion allograft (dHACA) versus standard of care (SOC) in facilitating wound closure in nonhealing DFUs. METHODS Patients with DFUs treated with SOC (off-loading, appropriate debridement, and moist wound care) after a 2-week screening period were randomized to either SOC or wound-size-specific dHACA (AmnioBand, Musculoskeletal Transplant Foundation, Edison, N.J.) applied weekly for up to 12 weeks plus SOC. Primary endpoint was the percentage of wounds healed at 6 weeks between groups. RESULTS At 6 weeks, 70% (14/20) of the dHACA-treated DFUs healed compared with 15% (3/20) treated with SOC alone. Furthermore, at 12 weeks, 85% (17/20) of the DFUs in the dHACA group healed compared with 25% (5/20) in the SOC group, with a corresponding mean time to heal of 36 and 70 days, respectively. At 12 weeks, the mean number of grafts used per healed wound for the dHACA group was 3.8 (median 3.0), and mean cost of the tissue to heal a DFU was $1400. The mean wastage at 12 weeks was 40%. One adverse event and 1 serious adverse event occurred in the dHACA group; neither was graft related. Three adverse events and 1 serious adverse event occurred in the SOC group. CONCLUSION Aseptically processed dHACA heals diabetic foot wounds significantly faster than SOC at 6 and 12 weeks with minimal graft wastage.
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Affiliation(s)
- Lawrence A. DiDomenico
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Dennis P. Orgill
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Robert D. Galiano
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Thomas E. Serena
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Marissa J. Carter
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Jarrod P. Kaufman
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Nathan J. Young
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
| | - Charles M. Zelen
- From the Lower Extremity Institute for Research and Therapy, Youngstown, Ohio; Department of Plastic Surgery, Brigham and Women’s Hospital, Boston, Mass.; Division of Plastic Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Ill.; Serena Group, Cambridge, Mass.; Strategic Solutions, Inc., Cody, Wyo.; *General Surgery, Premier Surgical, Brick, N.J.; †Martinsville Research Institute, Martinsville, Va.; and ‡Professional Education and Research Institute, Roanoke, Va
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