Hasegawa Mitsuhiro, Fujisawa Hironori, Hayashi Yutaka, Yamashita Junkoh
Department of Neurosurgery, Division of Neuroscience, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
J Clin Neurosci. 2004 May;11(4):408-11. doi: 10.1016/j.jocn.2003.11.006.
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.
Amniotic membrane, which was composed of amnion and chorion, was aseptically harvested at cesarean section. Removing chorionic tissue, amnion containing monolayer of amniotic epithelial cells and underlining fibrous tissue was isolated. After the procedure of reconstruction of neural and meningeal elements, the membrane was placed as onlay autograft over the reconstructed neural structure followed by suture of undermined skin flap without any myocutaneous flap transfer technique or fascial transposition from paraspinal muscles.
The postoperative healing process of the wound was excellent.
Autograft of amniotic tissue has no risks of rejection, foreign body reaction, or transmission of slow virus infection to reconstruct the lesion of newborn patient. Amnion autograft would be a biologic rationale to promote wound healing, being applied as a part of a variety of pediatric neurosurgical procedure.
羊膜在无菌获取时可作为自体重建移植材料。我们在此介绍一种使用自体羊膜移植的新型修复技术，并报告一例使用该移植材料成功治疗脊髓脊膜膨出的病例。
在剖宫产时无菌获取由羊膜和绒毛膜组成的羊膜。去除绒毛膜组织，分离出含有单层羊膜上皮细胞及下方纤维组织的羊膜。在重建神经和脑膜结构后，将该膜作为覆盖自体移植物置于重建的神经结构上，随后缝合潜行分离的皮瓣，未采用任何肌皮瓣转移技术或取自椎旁肌的筋膜转位。
伤口术后愈合过程良好。
羊膜组织自体移植在重建新生儿患者病变时无排斥、异物反应或慢病毒感染传播的风险。羊膜自体移植作为促进伤口愈合的生物学原理，可应用于多种小儿神经外科手术。
