Skip to main content Skip to main navigation menu Skip to site footer

Wound healing of gaster perforation with Human Dried Amniotic Membrane (H-DAM) as biomaterial patch viewing from the fibroblasts counts and collagen density

  • Astri Taufi Ramadhani ,
  • Ariandi Setiawan ,
  • I Gusti Bagus Adria Hariastawa ,


Link of Video Abstract:


Background: Gastric perforation in neonates is an emergency in neonatology with a mortality rate of up to 75%. Many studies have been carried out to improve tissue healing, including using various surgical techniques and materials, one of which is using H-DAM technology. Therefore, this study aims to evaluate the differences in the number of fibroblasts and collagen density in gastric perforation repair with H-DAM as a biomaterial patch compared to using an omental patch in New Zealand white rabbits.

Methods: A true-experimental study was conducted among 30 samples of rabbits and none of them dropped out. The inclusion criteria for this study are New Zealand White Rabbit male sex, age 6-9 months with a weight of 2-3 kg, healthy and active. The Exclusion criteria for this study are rabbits not fasted for 12 hours. During the 12-hour fasting period, it behaved aggressively, attacked other rabbits, and found surgical site infection. Data were analyzed using SPSS version 25.0 for Windows.

Results: From the examination results, there was a significant difference in gastric healing in terms of examining the number of fibroblasts with the Kruskal-Wallis test (p=0.000. The One-way ANOVA analysis found that the three data groups had no significant difference (p=0.234).

Conclusion: There is an increase in the number of fibroblasts and collagen density in gastric perforation repair with H-DAM as a biological dressing compared to primary repair of gastric perforation using an omental patch in rabbit models so that H-DAM can be the repair technique of choice in gastric perforation in the rabbit.


  1. Barmadisatrio, Mulluzi AS. Delayed laparotomy and gastric repair in gastric perforation: A case report in the neonatal patient. Bali Medical Journal. 2021;10(1):43–46.
  2. Arora BK, Arora R, Arora A. Modified Graham’s repair for peptic ulcer perforation: reassessment study. Int Surg J. 2017;4(5):1667-1671.
  3. Arai N, Tsuno H, Okabe M, Yoshida T, Koike C, Noguchi M, et al. Clinical application of a hyperdry amniotic membrane on surgical defects of the oral mucosa. J Oral Maxillofac Surg. 2012;70(9):2221–2228.
  4. Fénelon M, Catros S, Meyer C, Fricain JC, Obert L, Auber F, et al. Applications of Human Amniotic Membrane for Tissue Engineering. Membranes (Basel). 2021;11(6):387.
  5. Novriansyah R. Perbedaan Kepadatan Kolagen Di Sekitar Luka Insisi Tikus Wistar Yang Dibalut Kasa Konvensional Dan Penutup Oklusif Hidrokoloid Selama 2 Dan 14 Hari [Tesis]. Fakultas Kedokteran Universitas Diponegoro. 2008.
  6. Muzakkir Y, Adria Hariastawa I, Matulatan F. Freeze-dried Amniotic Membrane (FD-AM) Application to Fibroblast Growth Factor Expression on Urethral Defect Reconstruction in New Zealand White Rabbit (Oryctolagus cuniculus). Int J Res Publ. 2021;78(1):145–150.
  7. Pada S, New K. Efek Pemberian Membran Amnion Kering Terhadap Ekspresi Platelet Derived Growth Factor Pada Penyembuhan Luka Pasca Trauma Tembus Gaster (Studi Pada Kelinci New Zealand) Penelitian Prospektif Intervensional [Tesis]. Fakultas Kedokteran Universitas Airlangga. 2020
  8. Farghali HA, AbdElKader NA, Khattab MS, AbuBakr HO. Novel approach to gastric mucosal defect repair using fresh amniotic membrane allograft in dogs (experimental study). Stem Cell Res Ther. 2017;8(1):1–12.
  9. Barlas M, Gökçora H, Erekul S, Dindar H, Yücesan S. Human amniotic membrane as an intestinal patch for neomucosal growth in the rabbit model. J Pediatr Surg. 1992;27(5):597–601.
  10. Insausti CL, Alcaraz A, García-Vizcaíno EM, Mrowiec A, López-Martínez MC, Blanquer M, et al. Amniotic membrane induces epithelialization in massive posttraumatic wounds. Wound Repair Regen. 2010;18(4):368–377.
  11. Widhanar H, Matulatan F, Tanggo EH, Danardono E. Differences of dried amniotic membrane effect on healing of gastric tissue post penetrating trauma reviewed from collagen thickness and fibroblast count. Syst Rev Pharm. 2020;11(5):583–586.
  12. Lashgari MH, Rostami MHH, Etemad O. Assessment of outcome of using amniotic membrane enriched with stem cells in scar formation and wound healing in patients with burn wounds. Bali Medical Journal. 2019;8(1):41-56.
  13. Sungkar A, Widyatmoko D, Yarso KY, Wasita B. The effect of duration of wound skin tissue on MDA, TNF-α, IL-6, Caspase 3, VEGF levels, and granulation tissue thickness in the white rat (Rattus novergicus). Bali Medical Journal. 2020;9(3):918-923.
  14. Surjantoro A, Zarasade L, Hariani L. Comparison of the effectiveness between single and repeated administration of topical Tretinoin 0.05% on full-thickness acute wound healing. Bali Medical Journal. 2022;11(2):779-783.

How to Cite

Ramadhani, A. T. ., Ariandi Setiawan, & I Gusti Bagus Adria Hariastawa. (2023). Wound healing of gaster perforation with Human Dried Amniotic Membrane (H-DAM) as biomaterial patch viewing from the fibroblasts counts and collagen density. Bali Medical Journal, 12(3), 2378–2382.




Search Panel

Astri Taufi Ramadhani
Google Scholar
BMJ Journal

Ariandi Setiawan
Google Scholar
BMJ Journal

I Gusti Bagus Adria Hariastawa
Google Scholar
BMJ Journal