Enhanced survival and accelerated perfusion of skin flap to recipient site following administration of human amniotic membrane in rat models

The human amniotic membrane contains the cellular parts obligatory for cell integration and tissue remodeling and has high tensile strength and persistence. We theorized that such material could function as a scaffold to improve the survival of ischemic tissue in random skin flaps. Male Albino Wistar rats (n = 30) were randomly assigned to three groups, each receiving a different model of AM on dorsal paravertebral areas: saline, amniotic membrane sheet, and micronized amniotic membrane. Digital photographs were taken, and the survival area was examined after one week. Histological analysis of skin flap tissue was performed, and the expression rate of vascular endothelial growth factor and apoptotic protein was examined. The survival percentage increased over time in all groups; however, one week after the implanted AM was increased survival in both experimental groups, with significantly greater than in the group control. In the experimental groups, there was a more regular arrangement of collagen and improved epithelialization in the flap tissue, also an increased number of inflammatory cells was observed in the control group. Additionally, VEGF and apoptotic protein expression, respectively, were significantly lower and greater in the control group than in the experimental groups. These results show that micronized membrane is an excellent scaffold for promoting flap survival.