Rafati Mohammad, Hosseini Seyed Vahid, Moradian Farid, Zamani Mozhdeh, Khazraei Hajar, Mokhtari Maral
Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Surgery, Yasouj University of Medical Sciences, Yasouj, Iran.
Iran J Med Sci. 2018 Sep;43(5):473-478.
Perianal fistula is a complicated disorder and most difficult to manage. New treatment methods would help surgeons to achieve a better outcome in patients with perianal fistula. Human amniotic membrane (HAM) has positive effects on wound healing in several conditions. The present study aimed to further determine the effect of HAM on wound healing of perianal fistula in rabbits.
In a prospective experimental study, 14 male rabbits (aged 4-6 months and weighing 3-4 kg) were randomly divided into 2 groups. After 12 weeks, the high type perianal fistula was repaired with endorectal flap (ERF) and ERF plus HAM in the control and case groups, respectively. In all rabbits of the case group, a 1×1 cm width wrap of HAM was applied and fixed around the ERF site. Three weeks later, the repaired site of the perianal fistula was sent for pathologic wound healing scoring. The results were analyzed with the SPSS 21.0 software using Mann-Whitney test.
Six rabbits of each group survived the study period. There was a statistically significant difference in wound healing between the case and control groups (P<0.001). Wound healing process in the case group occurred better and faster than the control group.
HAM has an effective role in enhancing the ERF procedure and considered appropriate. A combination of HAM with other methods is recommended.
肛周瘘是一种复杂的病症,极难处理。新的治疗方法将有助于外科医生在肛周瘘患者中取得更好的治疗效果。人羊膜(HAM)在多种情况下对伤口愈合具有积极作用。本研究旨在进一步确定HAM对兔肛周瘘伤口愈合的影响。
在一项前瞻性实验研究中,将14只雄性兔(年龄4 - 6个月,体重3 - 4千克)随机分为2组。12周后,对照组和病例组分别采用直肠内瓣(ERF)和ERF加HAM修复高位肛周瘘。在病例组的所有兔子中,将一片1×1厘米宽的HAM包裹物应用并固定在ERF部位周围。3周后,将肛周瘘的修复部位送去进行病理伤口愈合评分。使用Mann - Whitney检验,用SPSS 21.0软件分析结果。
每组各有6只兔子存活至研究期结束。病例组和对照组在伤口愈合方面存在统计学显著差异(P<0.001)。病例组的伤口愈合过程比对照组更好、更快。
HAM在增强ERF手术方面具有有效作用,被认为是合适的。建议将HAM与其他方法联合使用。