Does freeze dried amnion useful as scaffold for mesenchymal stem cell for repair of vesicovaginal fistula? An overview of proliferative and remodeling phase in the wound healing process

Background: Surgery is still the main solution for vesicovaginal fistula, but postoperative wound healing represents a challenge, and the recurrence rate remains high. There is a need to develop therapeutic methods to increase the success of therapy and women's quality of life. Objective: To explore whether human freeze-dried amnion is useful as a mesenchymal stem cell scaffold for repair of vesicovaginal fistula through assessment of the proliferative and remodelling phases. Methods: This experiment was undertaken using a New Zealand rabbit model. The research was divided into two stages: (1) an experiment to create a model of a vesicovaginal fistula; and (2) a laboratory experiment to close a vesicovaginal fistula as a result of the first stage. The second stage used a post-test-only control group design. The wound-healing process was assessed based on the expression of platelet-derived growth factor (PDGF), vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF), occludin and claudin-4. Data were analysed descriptively and statistically. Results: Expression of PDGF, VEGF, FGF, occludin and claudin-4 in vesicovaginal fistula models sutured with human freeze-dried amnion was higher compared with models without human freeze-dried amnion. Significant differences were found in average expression of PDGF, VEGF, FGF, occludin and claudin-4. Conclusion: Human freeze-dried amnion plays a role in the wound-healing process in vesicovaginal fistula repair models. It is hoped that this research will improve urogynaecological services.