Simultaneous application of human amniotic membrane and Tachosil® in the repair of recto-vaginal fistula in an animal model
- 109 Downloads
Patients with recto-vaginal fistula (RVF) suffer from distressing symptoms like the passage of stool and gas through the vagina. Although surgeons employed various techniques to address this disorder, however, current techniques are invasive and their success rate is variable. Considering the notable features of human amniotic membrane (HAM) as a bio-prosthesis and Tachosil® as a type of biologic mesh, the present study was designed to assess the effect of HAM in the presence of Tachosil® on the repair of RVF in a rabbit model. Twelve New Zealand rabbits weighing 2–2.5 kg with the age of 6–8 months were selected, and RVF was created surgically in all of them. They were randomly divided into three groups for repair with HAM, repair with HAM in the presence of Tachosil®, and standard repair, respectively. Histopathological features were evaluated using modified scoring system. Statistical analysis was performed by SPSS software version 18 (SPSS Inc., Chicago, IL, USA) using the Kruskal-Wallis test. Gross examination and microscopic evaluation were performed after 4 weeks. Fistula healing occurred in all rabbits and no abscess or infection was detected. Microscopic fistula healing was scored based on epithelialization, collagenization, inflammation, neovascularization, necrosis, and granulation tissue. Differences among these three groups were not statistically significant (p > 0.05). Our findings revealed that the major positive effect on RVF repair was related to HAM and healing was not improved in the presence of Tachosil®. Further studies with larger sample size would be helpful for more detailed assessment.
KeywordsHuman amniotic membrane Tachosil® Recto-vaginal fistula Wound healing
This study was extracted from Dr. Haghpanah Aski dissertation (no. 7188). The authors would like to express their sincere gratitude to Shiraz University of Medical Sciences for financially supporting the study.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All applicable guidelines for the care and use of animals were duly followed and that approval was obtained from the Institutional Review Board (IRB) and Ethics Committee of Shiraz University of Medical Sciences.
- Adrain C, Barbl JA, Brunicord FC, Anersen DK, Billira TK, Dunn Di et al (2005) Wound healing. Schwartz principles of surgery. McGraw Hill, New York, pp. 233–249Google Scholar
- Iłżecki M, Zubilewicz T, Przywara S, Terlecki P (2013) The evaluation of the effectiveness of Tachosil in the treatment of lymphorrhea of the postoperative wound in the selected group of patients, after vascular reconstructive surgeries—preliminary report. Pol J Surg 85(12):687–692Google Scholar
- Mita K, Ito H, Murabayashi R, Asakawa H, Nabetani M, Kamasako A, Koizumi K, Hayashi T (2015) Use of a fibrinogen/thrombin-based collagen fleece (TachoComb, TachoSil) with a stapled closure to prevent pancreatic fistula formation following distal pancreatectomy. Surg Innov 22(6):601–605CrossRefPubMedGoogle Scholar
- Najibpour N, Ahmed MAAH, Bananzadeh A, Rezaianzadeh A, Kermani MR, Gabash KM, Tajali H, Hosseini SV, Mehrabani D (2016) The effect of human amniotic membrane as a covering layer on propylene mesh in decrease of adhesion after laparotomy in the rabbit. Comp Clin Path 25(1):131–135CrossRefGoogle Scholar
- Tahamtan M, Hosseini SV, Khazraei H, Forozesh M, Bananzadeh A, Mokhtari M, Fereidooni S (2016) Effect of human amniotic membrane on anastomosis leakage in dog model. Comp Clin Path 25(6):1121–1126Google Scholar
- Uludag M, Ozdilli K, Citgez B, Yetkin G, Ipcioglu OM, Ozcan O, Polat N, Kartal A, Torun P, Isgor A (2010) Covering the colon anastomoses with amniotic membrane prevents the negative effects of early intraperitoneal 5-FU administration on anastomotic healing. Int J Color Dis 25(2):223–232CrossRefGoogle Scholar