Foetal
wounds are unique in their ability to heal rapidly without forming
scars. The amniotic fluid, rich in nutrients,
growth factors, and
hyaluronic acid, surrounds the foetus and is essential to foetal wound healing. The wound healing properties of foetal
wounds may be the result of high concentrations of
hyaluronic acid. This study aimed to verify that amniotic fluid induces re-epithelialisation in human skin
wounds in vitro and to study whether this ability is dependent on
hyaluronic acid. Standard deep dermal
wounds were produced in vitro in human skin. The skin samples, with a central
wound, were incubated in different
culture media. Varying concentrations of amniotic fluid and amniotic fluid with added
hyaluronidase were tested, and re-epithelialisation was assessed at 3, 7, and 12 days using light microscopy, after staining with haematoxylin and
eosin. Amniotic fluid 50% resulted in a significantly higher (p < 0.05) grade of re-epithelialisation than Dulbecco's modified Eagle's medium and 10% amniotic fluid at all time points. When 50% amniotic fluid was compared with 10% foetal calf serum, no significant difference was found in grades of re-epithelialisation on days 3 and 12 and significantly higher grades of re-epithelialisation on day 7 (p < 0.05). Degradation of
hyaluronic acid in the medium that contained 50% amniotic fluid gave significantly impaired re-epithelialisation (p < 0.05) on culture days 3 and 7. In conclusion, amniotic fluid promotes accelerated re-epithelialisation and
hyaluronic acid is an important ingredient.