Using amniotic membrane for effective epithelialization of surgical wounds after cesarean section

Authors

1 Institute of Genetics and Physiology, Committee of Science Ministry of Science and Higher Education of the Republic of Kazakhstan, Almaty, Kazakhstan

2 Non-Profit Joint Stock Company “S.D. Asfendiyarov Kazakh National Medical University,” Almaty, Kazakhstan

3 LLP “Scientific and Production Technical Center ‘Zhalyn’,” Almaty, Kazakhstan

10.22124/cjes.2025.9377

Abstract

The purpose of this clinical trial, conducted on 80 patients between March and December 2024 referred to Almaty Teaching Hospital, was to evaluate the effect of amniotic membrane on wound healing after cesarean section. Patients were randomly divided into two intervention groups-recipients of amniotic membrane-and control-recipients of standard dressing. The results showed that the time to complete epithelialization in the intervention group was an average of 10.2 days, being significantly lower than 15.8 days in the control group, with a p-value of less than 0.001. Moreover, the incidence of wound infection was only 2.5% in the intervention group, while this rate reached 17.5% in the control group, with a p-value of 0.025. Based on the VAS scale, pain intensity in the intervention group was significantly lower than in the control group during all early postoperative days. Furthermore, assessment of patient satisfaction and scar appearance based on the POSAS questionnaire was also more favorable in the intervention group. Finally, the length of hospitalization was shorter in this group. This study concludes that the application of amniotic membrane can be integrated as an effective complementary method in post-cesarean care protocols by accelerating recovery, reducing complications, and increasing patient satisfaction.
 

Keywords


Budny-Wińska, J, Zimmer-Stelmach, A & Pomorski, M 2021, Impact of selected risk factors on uterine healing after cesarean section in women with single-layer uterine closure: A prospective study using two- and three-dimensional transvaginal ultrasonography. Advances in Clinical and Experimental Medicine, 30(12): 1257-1264, https://doi.org/10.17219/acem/142519.
Derenska, Ya 2019, Approaches to project portfolio formation by pharmaceutical products producers. Economic Annals-XXI, 176(3-4): 99-108, https://doi.org/10.21003/ea.V176-10.
Elsayed, HF, Gaber, M, Zaghloul, M & Osman, SA 2024, Effect of immediate nursing intervention regarding applying amniotic membrane on pain and healing of cesarean wound. Tanta Scientific Nursing Journal, 25(1): 45-58, https://doi.org/10.21608/tsnj.2024.346139.
Grotegut, C, Weaver, KE, Fried, L, Dotters-Katz, SK & Gilner, J 2024, The collection and application of autologous amniotic fluid to cesarean delivery closure. AJP Reports, 14(03): e178-e183. https://doi.org/ 10.1055/a-2445-7954.
Hameed, HI & Al-Mayahy, MH 2024, Combined approach of nanoemulgel and microneedle pre-treatment as a topical anticellulite therapy. ADMET and DMPK, 12(6): 903-923.
Hassan, WM & Mohammad, AA 2024, Analgesic effects of intraarticular anaesthetic lidocaine and methylprednisolone versus methylprednisolone alone following knee arthroscopy. ADMET and DMPK, 12(4): 679-685.
Hussein, UAR, Hameed, SM, Dadaxon, A, Altimari, US, Hussein, MA, Bokhoor, SN, Aljeboree, AM & Alkaim, A F 2025, Green adsorbents for pharmaceutics removal from aqueous solution: Regeneration and reused for environmental study. Procedia Environmental Science, Engineering and Management, 12(1): 229-235.
Islam, MFA, Wirawan, NS, Arif, SK, Hisbullah, Husain, AAA & Adil, A 2025, Perioperative management of renin-angiotensin system inhibitors in hypertensive patients undergoing non-cardiac surgery. Revista Latinoamericana de Hipertensión, 20(9), https://doi.org/10.5281/zenodo.17314566.
León-Campos, MI, Mendoza, J J, Aguayo-Morales, H, Cobos-Puc, LE, Cabrera-Munguía, DA & Claudio-Rizo, J A 2024, The biological applications of IPN hydrogels. ADMET and DMPK, 12(4): 581-621.
Lofrumento, D, Di Nardo, M, De Falco, M & Di Lieto, A 2016, Uterine wound healing: A complex process mediated by proteins and peptides. Current Protein & Peptide Science, 17(8): 774-785, https://doi.org/ 10.2174/1389203717666160322145939.
Loorakagha, A, Ashrafganjoei, T, Mirzaei, M, Mansouri, G, Shojaei, F, Abedi, S & Sohbati, S 2025, Comparison of short-term neonatal hemodynamic and metabolic outcomes in preterm births by mode of delivery. Revista Latinoamericana de Hipertension, 20(7): 488-496.
Mikaeili, A, Naghibzadeh, ZAS, Mohammadi, V, Norooznezhad, A, Mansouri, K & Jalilian, N 2025, Application of cryopreserved decellularized human amniotic membrane for healing of treatment-resistant cesarean section wounds: A case series. Advances in Skin & Wound Care, 38(2): 1-7, https://doi.org/ 10.1097/asw.0000000000000325.
Parmar, UPS, Surico, P, Scarabosio, A, Singh, RB, D'Ancona, F, Zeppieri, M, Parodi, PC, Mori, T, Cutrupi, F, Ma, D H-K, Di Zazzo, A & Coassin, M 2025, Amniotic Membrane Transplantation for Wound Healing, Tissue Regeneration and Immune Modulation. Stem Cell Reviews and Reports, 21(4): 1123-1141, https://doi.org/10.1007/s12015-025-10892-x.
Peng, X, Xu, J, Tian, Y, Liu, W & Peng, B 2020, Marine fish peptides (collagen peptides) compound intake promotes wound healing in rats after cesarean section. Food & Nutrition Research, 64: 4247, https://doi.org/10.29219/fnr.v64.4247.
Rakhmatova, M, Yulchiev, A, Akhmedov, R, Raimov, K, Karimova, D, Sapayev, V & Zokirov, K 2025, Application of antibacterial carbon nanotubes in food and pharmaceutical packaging industry. Procedia Environmental Science, Engineering and Management, 12(1): 187-194.
Ruiz-Cañada, C, Bernabé-García, Á, Liarte, S, Rodríguez-Valiente, M & Nicolás, F J 2021, Chronic wound healing by amniotic membrane: TGF-β and EGF signalling modulation in re-epithelialization. Frontiers in Bioengineering and Biotechnology, 9: 689328. https://doi.org/10.3389/fbioe.2021.689328.
Sawicki, M, Nowak, W, Gołębski, M, Mikołajczyk, J, Kukla, Z, Mieruszyńska, S, Krzemińska, P, Sadowska, I, Włosiański, J & Musialik, S 2025, Postoperative Wound Complications in Obstetrics and Gynecology. Treatment and prevention methods. Journal of Education, Health and Sport, 79: 58174-58187, https://doi.org/10.12775/jehs.2025.79.58174.
Setiawan, WA, Sanjaya, I, Suardika, A, Widiyanti, ES & Kalimantara, PNAP 2023, The Benefit of Amniotic Membrane as A Surgical Wound Dressing for Post Cesarean Section. European Journal of Medical and Health Sciences, 5(3): 1675-1682, https://doi.org/10.24018/ejmed.2023.5.3.1675.
Sitepu, M, Rizaldi, M & Siddik, D 2023, Ultrasound evaluation of post-cesarean uterine wound healing based on a figure of eight suturing technique. Bali Medical Journal, 12(2): 2248-2253, https://doi.org/10.15562/ bmj.v12i2.4241.
Tahermanesh, K, Hanjani, S, Saadat Mostafavi, SR, Shahriyari, R, Anvari‐Yazdi, AF, Karimi-Zarchi, M, Samimi, M, Karimi, A, Allahqoli, L & Alkatout, I 2021, Hourglass cesarean scar: A neglected external niche in association with the internal niche. International Journal of Gynecology & Obstetrics, 155(3): 447-453, https://doi.org/10.1002/ijgo.14052.
Tobin, MJ, Mustoe, AK, Nickman, S, Raquepo, T, Yamin, M, Posso, AN, Karinja, SJ, Lee, BT & Cauley, RP 2025, Comparing amniotic membranes to other bioengineered skin substitutes in wound healing: A propensity score-matched analysis. Journal of Clinical Medicine, 14(12): 4272, https://doi.org/ 10.3390/jcm14124272.
Tretyakova, L, Spichak, I, Zhirova, I, Tkhorikov, B & Evtushenko, E 2021, Hiring in pharmaceutical organizations: procedural aspects of personnel assessment. Economic Annals-XXI, 194(11-12): 59-66, https://doi.org/10.21003/ea.V194-07.
Umarov, F, Rovshon, M, Dadaxon, A, Zafar, N, Davron, K, Khurmatkhon, K & Inomjon, M 2025, Efficacy of digital health applications in improving treatment adherence among patients with resistant hypertension: a randomized controlled trial. Revista Latinoamericana de Hipertensión, 20(7), https://doi.org/10.5281/ zenodo.16156327.
Zhang, L & Zhe, K 2024, Causes of poor incision healing after caesarean section and strategies to prevent it. Journal of Clinical Medicine Research, 5(2): 45-52, https://doi.org/10.32629/jcmr.v5i2.2309
ZHU, H, Liu, F, Liao, Y, Li, H, Gao, K, Liang, X, Jiang, H, Chen, F, Wu, J, Wang, Q, Wang, Y, Shuai, X & Yi, X 2025, Biomimetic nanostructural materials based on placental amniotic membrane-derived nanofibers for self-healing and anti-adhesion during cesarean section. Biomaterials, 310: 123081, https://doi.org/ 10.1016/j.biomaterials.2024.123081.
Volume 23, Issue 5
Special issue: Biological Researches and Envireonment, Guest Editor: Prof. Hamed Mousavi-Sabet, University of Guilan, Iran
December 2025
Pages 1379-1386