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A novel use of amniotic membrane for fingertip injuries

A novel use of amniotic membrane for fingertip injuries

Fijan A, Hashemi A, Namazi H 18 May 2014

Journal of wound care (2014)
Fingertip injuries, which are the most common hand injury, represent management challenges for hand surgeons. Full thickness skin grafts are routinely used to cover the fingertip site, but has significant donor site morbidity. As amniotic membranes (AM) are used as a dressing substitute in burns, we decided to evaluate the efficacy of AM as a biologic wound dressing material for coverage of these injuries.

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Autologous amnion graft for repair of myelomeningocele: technical note and clinical implication

Autologous amnion graft for repair of myelomeningocele: technical note and clinical implication

Mitsuhiro Hasegawa, Hironori Fujisawa, Yutaka Hayashi, Junkoh Yamashita 20 May 2004

Journal of Clinical Neuroscience (2004) 11(4), 408–411

Amniotic membrane can be used as autologous reconstruction graft material when aseptically obtained. We introduce here a novel repair technique using autologous amnion graft, and report a case presentation of myelomeningocele successfully treated with this graft material.

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Cross-facial nerve grafting for facial reanimation

Cross-facial nerve grafting for facial reanimation

Peng GL, Azizzadeh B 30 April 2015

Dynamic facial reanimation is the gold standard treatment for a paralyzed face. Over the last century, multiple nerves have been utilized for grafting to the facial nerve in an attempt to produce improved movement. However, in recent years, the use of cross facial nerve grafting with a second stage gracilis free flap has gained popularity due to the ability to generate a spontaneous smile and facial movement. Preoperative history taking and careful examination, as well as pre-surgical planning, are imperative to whether cross facial nerve grafting with a second stage gracilis free flap is appropriate for the patient. A sural nerve graft is ideal given the accessibility of the nerve, the length, as well as the reliability and ease of the nerve harvest. The nerve can be harvested using a small incision, which leaves the patient with minimal post operative morbidity. In this chapter, we highlight the pearls and pitfalls of cross facial nerve grafting.

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Dehydrated Human Amnion/Chorion Membrane Allograft Nerve Wrap Around the Prostatic Neurovascular Bundle Accelerates Early Return to Continence and Potency Following Robot-assisted Radical Prostatectomy: Propensity Score–matched Analysis

Dehydrated Human Amnion/Chorion Membrane Allograft Nerve Wrap Around the Prostatic Neurovascular Bundle Accelerates Early Return to Continence and Potency Following Robot-assisted Radical Prostatectomy: Propensity Score–matched Analysis

Vipul R. Patel, Srinivas Samavedi, Anthony S. Bates, Anup Kumar, Rafael Coelho, Bernardo Rocco, Kenneth Palmer 20 May 2013

European Association of Urology (2015) Article in press

We present a propensity-matched analysis of patients undergoing placement of dehydrated human amnion/chorion membrane (dHACM) around the neurovascular bundle (NVB) during nerve-sparing (NS) robot-assisted laparoscopic prostatectomy (RARP).

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Dehydrated Human Amnion/Chorion Membrane Allograft Nerve Wrap Around the Prostatic Neurovascular Bundle Accelerates Early Return to Continence and Potency Following Robot-assisted Radical Prostatectomy: Propensity Score–matched Analysis European Association of Urology (2015) Article in press

Dehydrated Human Amnion/Chorion Membrane Allograft Nerve Wrap Around the Prostatic Neurovascular Bundle Accelerates Early Return to Continence and Potency Following Robot-assisted Radical Prostatectomy: Propensity Score–matched Analysis European Association of Urology (2015) Article in press

Vipul R. Patel, Srinivas Samavedi, Anthony S. Bates, Anup Kumar, Rafael Coelho, Bernardo Rocco, Kenneth Palmer 06 June 2015

We present a propensity-matched analysis of patients undergoing placement of dehydrated human amnion/chorion membrane (dHACM) around the neurovascular bundle (NVB) during nerve-sparing (NS) robot-assisted laparoscopic prostatectomy (RARP).

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Homologous cryopreserved amniotic membrane in the repair of myelomeningocele: preliminary experience

Homologous cryopreserved amniotic membrane in the repair of myelomeningocele: preliminary experience

Marton E, Giordan E, Gioffrè G, Canova G, Paolin A, Mazzucco MG, Longatti P. 01 June 2018

Acta Neurochir (Wien). 2018 Aug;160(8):1625-1631.7

Abstract

OBJECTIVE: Surgical management of spinal dysraphism often requires the use of dural substitutes. Amniotic membrane (AM) has drawn the interest of clinicians for its valuable concentration of cytokines and factors capable of promoting wound healing, re-epithelialization, inhibiting fibrosis and regulating angiogenesis. These beneficial qualities could make AM an interesting dural substitute for spina bifida repair. In this study, we describe the use of banked homologous AM as a dural substitute for the repair of spinal dysraphism in newborns. Our purpose is to test the mechanical characteristics, as well as the safety and effectiveness of AM in preventing postoperative complications and re-tethering.

METHODS: The AM patch was carefully detached from the chorion of donors undergoing caesarean section, rinsed in saline solution, and cryopreserved in liquid nitrogen. Five newborns were treated using AM: three affected by open spinal dysraphism and two by spina bifida occulta. The AM patch was used as a dural substitute with two different positions and purposes: the amnion-side down covering the placode to prevent adhesions or placed extradurally facing the dura to avoid scarring and facilitating the sliding of the dural sac itself under the extradural tissue layers.

RESULTS: No adverse events occurred, and the surgical wounds healed without complications. MRI scans taken at 3 and 6 months after surgery showed a satisfying de-tethering of the spinal cord with no obvious evidence of new adherence formation.

CONCLUSIONS: We present a multimodal interposition technique using AM as a reconstructive and anti-adhesive tissue for the treatment of open myelomeningocele (MMC) and lipomeningocele (LMC) treatment. In our experience, AM proved its efficacy in restoring the dural sac integrity without complications. We support the use of AM as a promising dural substitute, speculating on how the use of AM could potentially change reconstructive strategies for spinal dysraphism.

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Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions

Implantation of amniotic membrane to reduce postlaminectomy epidural adhesions

Huiren Tao, Hongbin Fan 20 May 2015

 

Eur Spine J (2009) 18:1202–1212

Postlaminectomy epidural adhesion is implicated as a main cause of ‘‘failed back surgery Syndrome'' and associated with increased risk of complications during revision surgery. Various materials acting as mechanical barriers to reduce fibroblasts infiltration into epidural space

have met with limited success. In present research, amniotic membrane (AM) was studied to investigate its effects on reducing epidural scar adhesion after laminectomy in a canine model.

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Improving electrophysiologic and histologic outcomes by photochemically sealing amnion to the peripheral nerve repair site

Improving electrophysiologic and histologic outcomes by photochemically sealing amnion to the peripheral nerve repair site

Francis P. Henry, Namita A. Goyal, William S. David, David Wes, BA, Kenneth E. Bujold, BS, Mark A. Randolph, MAS, Jonathan M. Winograd, Irene E. Kochevar, and Robert W. Redmond, Boston, Mass 20 May 2015

Surgery (2009)

The surgical approach used today in the repair of peripheral nerve injuries rarely achieves full functional recovery. This study determines whether isolation of the nerve repair site using hotochemical tissue bonding (PTB) in combination with human amniotic membrane can improve both functional and histologic recovery.

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Improving electrophysiologic and histologic outcomes by photochemically sealing amnion to the peripheral nerve repair site

Improving electrophysiologic and histologic outcomes by photochemically sealing amnion to the peripheral nerve repair site

Francis P. Henry, Namita A. Goyal, William S. David, David Wes, BA, Kenneth E. Bujold, BS, Mark A. Randolph, MAS, Jonathan M. Winograd, Irene E. Kochevar, and Robert W. Redmond, Boston, Mass 20 May 2015

Surgery (2009)

The surgical approach used today in the repair of peripheral nerve injuries rarely achieves full functional recovery. This study determines whether isolation of the nerve repair site using hotochemical tissue bonding (PTB) in combination with human amniotic membrane can improve both functional and histologic recovery.

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Nerve regeneration across cryopreserved allografts from cadaveric donors: a novel approach for peripheral nerve reconstruction

Nerve regeneration across cryopreserved allografts from cadaveric donors: a novel approach for peripheral nerve reconstruction

Squintani G, Bonetti B, Paolin A, Vici D, Cogliati E, Murer B, Stevanato G. 31 October 2013

The use of allografts from cadaveric donors has attracted renewed interest in recent years, and pretreatment with cryopreservation and immunosuppression methods has been investigated to maximize axonal regrowth and minimize allograft rejection. The authors wanted to assess the outcome of treatments of brachial plexus stretch injuries with cryopreserved allografts from cadaveric donors in nonimmunosuppressed patients.

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New Dried Human Amniotic Membrane Is Useful as a Substitute for Dural Repair after Skull Base Surgery

New Dried Human Amniotic Membrane Is Useful as a Substitute for Dural Repair after Skull Base Surgery

Takahiro Tomita, Nakamasa Hayashi, Motonori Okabe, Toshiko Yoshida, Hideo Hamada, Shunro Endo, Toshio Nikaido 20 May 2015

J Neurol Surg B 2012;73:302–307.

Cerebrospinal fluid (CSF) leakage is an undesirable complication of skull base surgery.We used dried human amniotic membrane (AM) as a patch graft for dural repair to determine its efficacy in preventing CSF leakage.

 

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Pubblicazione Scientifica

Pubblicazione Scientifica

Procopio O, Trojan D, Frigo AC, Paolin A 30 May 2019

Use of homologous bone for alveolar crest reconstruction in 483 patients with 5 years' outcomes post implantation

Oral Maxillofac Surg. 2019 May 30. doi: 10.1007/s10006-019-00781-2.

Procopio O, Trojan D, Frigo AC, Paolin A

Abstract

PURPOSE: The purpose of this study was to evaluate the clinical course of bone reconstruction of the alveolar crest using homologous fresh-frozen bone harvested from deceased donors.

METHODS: A retrospective survey was based on the Castelfranco Veneto Hospital database, in which 3264 clinical records with a primary or secondary diagnosis of alveolar atrophy were collected over a 10-year period. A random sample of 483 patients with at least 5 years' follow-up was included in the survey. Patients were contacted by telephone and administered a questionnaire with specific questions to build a significant sample.

RESULTS: Of the patients, 449 (93% of the sample) had an uneventful follow-up after surgery and 93.2% received at least one implant, with a mean of 3.4 implants per patient. At the time of the survey, 93% of the patients were wearing a dental prosthesis, 86.9% had not lost any implants, and 6.7% had lost at least one implant, while 6.4% still had implants but presented some clinical problems. Finally, patients were asked to provide an index score (1-10 points) on the therapy as a whole, i.e., bone graft, implants, and prostheses. A score of insufficient (up to 5 points) was given by 5.3% of patients, of sufficient (6 to 7 points) by 6.1%, and of good/very good (over 7) by 88.6%.

CONCLUSIONS: Homologous bone for alveolar crest reconstruction can be a valid alternative to autologous grafting if specific tissue limitations are considered when planning therapy. Creeping substitution is partial and slower than in autologous grafts, especially in cases where cortical bone is thick or volume graft is very large. The quality of soft tissue coverage and mucosa lining is also important, possibly due to slower tissue revascularization, so future implants should predictably be positioned primarily within the original host bone.

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Spinal duraplasty with two novel substitutes restored locomotor function after acute laceration spinal cord injury in rats

Spinal duraplasty with two novel substitutes restored locomotor function after acute laceration spinal cord injury in rats

Hongsheng Liang, Changyu Li, Aili Gao, Peng Liang, Yongxiang Shao, Tie Lin, Xiangtong Zhang 20 May 2015

WILEY PERIODICALS, 2012

A dural tear is a common complication after acute laceration spinal cord injury (ALSCI). An unrepaired dural tear is associated with poor locomotor functional recovery. Spinal duraplasty with biomaterials may promote functional recovery in ALSCI. However, an ideal dural substitute has not yet been found. In this work, we investigated the possibility of using a denuded human amniotic membrane (DHAM) or DHAM seeded on bone marrow stromal cells (DHAM–BMSCs) as duraplasty biomaterials                                                         

              

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Techniques and materials for enhancement of peripheral nerve regeneration: a literature review.

Techniques and materials for enhancement of peripheral nerve regeneration: a literature review.

Siemionow M, Uygur S, Ozturk C, Siemionow K. 03 May 2014

Peripheral nerve surgery performed under unfavorable conditions results in increased scar formation and suboptimal clinical outcomes. Providing the operated nerve with a protective barrier, reduces fibrosis and adhesion formation and may lead to improved outcomes. The ideal coverage material should prevent scar and adhesion formation, and maintain nerve gliding during motion. Nerve protection using autologous tissues has shown good results, but shortcomings include donor site morbidity and limited availability. Various types of methods and materials have been used to protect nerves. There are both advantages and disadvantages associated with the various materials and techniques. In this report we summarize currently used protective materials applied for nerve coverage under various surgical conditions.

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The amnion muscle combined graft (AMCG) conduits: a new alternative in the repair of wide substance loss of peripheral nerves

The amnion muscle combined graft (AMCG) conduits: a new alternative in the repair of wide substance loss of peripheral nerves

Riccio, Pangrazi, Parodi, Vaienti, Marchesini, Neuendorf, Bottegoni, Tos, Geuna 18 August 2014

Microsurgery DOI 10.1002/micr

In this report, we present a completely new tubulization method, the amnion muscle combined graft (AMCG) technique, that consists in the combination of the human amniotic membrane hollow conduit with autologous skeletal muscle fragments for repairing the substance loss of peripheral nerves and recover both sensory and motor functions.

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Treatment for infection of artificial dura mater using free fascia lata

Treatment for infection of artificial dura mater using free fascia lata

Nakano T, Yoshikawa K, Kunieda T, Arakawa Y, Kikuchi T, Yamawaki S, Naitoh M, Kawai K, Suzuki S. 05 July 2014

The Journal of craniofacial surgery (2014)

Synthetic artificial dura mater materials, such as expanded polytetrafluoroethylene sheets, are widely used in dura mater reconstruction in cases involving brain tumors or trauma surgery. In patients with postoperative infection related to the use of artificial dura mater, surgical debridement of the infected wound and removal of the artificial dura mater materials are necessary to control infection. In cases involving cerebrospinal fluid leakage, dura mater reconstruction must be performed immediately. Many useful techniques for performing dura mater reconstruction to treat postoperative infection have been reported; however, some have drawbacks with respect to the need for microvascular anastomosis or difficulties in obtaining watertight closure. We successfully treated 6 patients with postoperative artificial dura mater infection using free thigh fascia lata. Some surgeons believe that the use of free fascia in infected wounds is dangerous because free fascia is a non-vascularized tissue.

 

 

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