J Korean Orthop Assoc.  2008 Jun;43(3):276-286. 10.4055/jkoa.2008.43.3.276.

The Effect of Human Amniotic Membrane, Epidermal Cells and Marrow Mesenchymal Stem Cells in Healing a Skin Defect

• Kim CH
• Kim SS
• Shon SK
• Kim DH
• Song CG
• Kim HJ

• KMID: 2186442
• DOI: http://doi.org/10.4055/jkoa.2008.43.3.276

Abstract

PURPOSE: The purpose of this study was to investigate the transplantation results of human amniotic membrane (HAM), epidermal cells, or marrow mesenchymal stem cells (MSCs) in healing a skin defect.
MATERIALS AND METHODS
Defects (full-thickness) in rabbits were treated with HAM alone (group A), HAM injected with cultivated epidermal cells (group B), HAM injected with cultivated MSCs (group C), or Vaseline gauze (group D). Tissue granulation, regeneration, re-epithelization and healing time were measured. Defects and healed area were calculated 2 weeks after surgery.
RESULTS
The mean healing area was 67.5%, 81.7%, 83.2% and 49.5% in each group, with all treatment groups significantly different than group D (p<0.01), and groups B and C compared higher than group A (p<0.05). The healing time of groups A, B, and C was 5.7 to 6.4 days faster than that of group D (p<0.01). Histologic analysis showed that the new epidermis covered nearly the whole wound surface in group B and C, and contained granulated tissue with fibroblasts, capillaries, and collagen.
CONCLUSION
HAM grafts injected with cultivated epidermal cells or MSCs promoted healing of skin defects.

Keyword

Amniotic membrane; Epidermal cells; MSCs; Skin defect

MeSH Terms

Amnion
Bone Marrow
Capillaries
Collagen
Epidermis
Fibroblasts
Humans
Mesenchymal Stromal Cells
Petrolatum
Rabbits
Regeneration
Skin
Transplants
Collagen
Petrolatum

Figure

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  Fig. 1 (A) Incision of a 3×3 cm size of full-thickness skin for collection of epidermal cells. (B) Aspiration and collection of 10 cc bone marrow mesenchymal stem cells in the rabbit femur.

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  Fig. 2 Photographs of cultivated epidermal cells and mesenchymal stem cells in vitro. (A) Epidermal cells (total cells: 6.8×106, 5 cc). (B) Mesenchymal stem cells (total cells: 6.8×106, 5 cc).

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  Fig. 3 A full-thickness skin defect of 2×2 cm in the rabbit.

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  Fig. 4 Graft procedures in each group. (A) Sutured graft of human amniotic membrane. (B) Injection of epidermal cells or mesenchymal stem cells under the human amniotic membrane. (C) Wound covered with Vaseline gauze.

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  Fig. 5 Comparison of HAM alone (A), HAM with epidermal cells (B), HAM with MSCs (C), and the Vaseline gauze (D) group 1 week post-graft (HAM, human amniotic membrane; MSCs, mesenchymal stem cells).

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  Fig. 6 Comparison of HAM alone (A), HAM with epidermal cells (B), HAM wih MSCs (C), and the vaseline gauze (D) group 2 weeks post-graft (HAM, human amniotic membrane; MSCs, mesenchymal stem cells).

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  Fig. 7 Histologic finding in group A. (A) Healed tissue shows a moderately recovered, relatively thin epidermis, but a completely healed skin appendage (×40). (B) Increased vascularity, little lymphocytic infiltration, and minimal fibrosis are noted in the dermis (×200).

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  Fig. 8 Histologic finding in group B. (A) Healed tissue shows a regenerated epidermis and recovered skin appendage (×40). (B) The dermis shows a few infiltrated inflammatory cells and mild fibrosis (×200).

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  Fig. 9 Histologic finding in group C. (A) Healed tissue shows a regenerated epidermis and recovered skin appendage (×40). (B) The dermis shows mild lymphoplasma cell infiltration and hemorrhaging; with abundant vasculature and minimal fibrosis are noted (×200).

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  Fig. 10 Histologic finding in group D. (A) Healed tissue shows an irregular and flattened ridge in the epidermis and the skin appendage is mostly absent (×40). (B) The dermis shows marked fibrosis with some lymphocyte infiltration and poor vasculature (×200).

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