Effects of Acellular Amniotic Membrane Matrix and Bone Marrow-Derived Mesenchymal Stem Cells in Improving Random Skin Flap Survival in Rats

Farzaneh Chehelcheraghi, Lorestan University of Medical Sciences and Hossein Eimani, Lorestan University of Medical Sciences and Seyed Homayoonsadraie, Lorestan University of Medical Sciences and Giti Torkaman, Tarbiat Modares University and Abdollah Amini, Shahid Beheshti University of Medical Sciences and Hamid Alavi Majd, Shahid Beheshti University of Medical Sciences and Hashem Shemshadi, University of Welfare and Rehabilitation Sciences (2016) Effects of Acellular Amniotic Membrane Matrix and Bone Marrow-Derived Mesenchymal Stem Cells in Improving Random Skin Flap Survival in Rats. Iran Red Crescent Med J, 18 (6).

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Abstract

Background: The necrotic skin flap represents a great challenge in plastic and reconstructive surgery. In this study, we evaluated the effect of bioscaffolds, acellular amniotic membranes (AAMs), and bone marrow-derived mesenchymal stem cells (BM-MSCs) on random skin flap (RSF) survival in rats by applying a cell-free extracellular matrix scaffold as a supportive component for the growth and proliferation of BM-MSCs on RSFs. AAM matrix scaffolds were created by incubating AMs in ethylenediaminetetraacetic acid 0.05% at 37°C, and cell scrapers were used. Objectives: The aim of the present study was to assess the effect of AAM as a scaffold in TE, and combined with transplanted BMMSCs, on the survival of RSFs and on the biomechanical parameters of the incision-wound flap margins 7 days after flap elevation. Materials and Methods: BM-MSCs and AAMs were transplanted into subcutaneous tissue in the flap area. On the 7th postoperative day, the survivingflapareas weremeasuredusing digital imaging software, andtheflaptissuewascollected for evaluation. Forty rats were randomly divided into four groups of 10 each: group 1 received an AAM injection; group 2 underwent BM-MSC transplantation; group 3 received both AAM injection + BM-MSC transplantation; and group 4 was the control group, receiving only saline. Results: The survival area in the AAM/BM-MSC group was significantly higher than in the control group (18.49�1.58 versus 7.51� 2.42, P < 0.05). The biomechanical assessment showed no significant differences between the experimental groups and the control group (P > 0.05), and there was no correlation with flap survival. Conclusions: Our findings showed that the treatment of flaps with BM-MSC and AAM transplantations significantly promoted flap survival compared to a control group. The viability of the flap was improved by combining BM-MSCs with AAM matrix scaffolds. Keywords: Amnion, Surgical Flaps, Mesenchymal Stromal Cells, Bone Marrow, Rats

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