Article
Repair of vesico-vaginal fistula with amniotic membrane – Step 1 of IDEAL recommendations of surgical innovation
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Published: | February 25, 2016 |
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Introduction: Amniotic membrane (AM) plays an increasing role as scaffold for the repair of defect tissue due to its unique biological properties which promote wound healing. AM is characterized by its durability and elasticity, it is antibacterial, non-antigenic and its stroma contains growth factors and cytokines.
Material and methods: We present a unique case of AM-assisted abdominal repair of a complex vesico-vaginal fistula (VVF) in a 64-year women after multiple abdominal surgery and radio-chemotherapy as Idea Stage following the IDEAL recommendations of surgical innovation. Homolog AM was harvested after cesarean section, cryopreserved, dried, prepared in three layers and was used as a graft to close the VVF-defect. Perioperative complications and functional results were obtained during the follow-up of 3, 6 and 12 mos.
Results: No severe complications, no graft rejection and no recurrent fistula were detected during the follow-up. The partial ingrowth of surrounding tissue on AM was found during cystoscopy.
Conclusion: For the first time we applied amniotic membrane graft assisted fistula repair. Following the IDEAL recommendations of surgical innovation preliminary case report showed the feasibility of the method. Further animal, cohort and randomised studies are needed to prove the procedure.