{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:45:34Z","timestamp":1790153134996,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,2,2]],"date-time":"2016-02-02T00:00:00Z","timestamp":1454371200000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ultrasound in Obstet &amp; Gyne"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To identify a patch system to repair surgically created spina bifida in a sheep model for its efficacy in healing the skin defect, protecting the underlying spinal cord and reducing the Chiari <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> malformation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Spina bifida was created surgically in 16 fetuses from eight timed\u2010pregnant sheep at gestational age of 75 days. Two fetuses did not survive the procedure. Repeat hysterotomy was performed at 95 days' gestation to cover the defect with either biocellulose film with underwater adhesive (<jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive) (<jats:italic>n<\/jats:italic> = 7) or human umbilical cord with suture (<jats:styled-content style=\"fixed-case\">HUC<\/jats:styled-content>\u2010suture) (<jats:italic>n<\/jats:italic> = 7). Three fetuses without formation of the defect served as reference controls. The skin healing was examined by direct visualization after a planned Cesarean section at term, followed by histological analysis using hematoxylin and eosin and Masson's trichrome stains. Mid\u2010sagittal sections of the fetal cranium and upper cervical spine were analyzed by a pediatric neuroradiologist who was blinded to the type of patch received.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Three fetuses that received the <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive and six fetuses that received the <jats:styled-content style=\"fixed-case\">HUC<\/jats:styled-content>\u2010suture survived to term for final analysis. As a result of dislodgment of the <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive, all spina bifida defects repaired using <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive were not healed and showed exposed spinal cord with leakage of cerebrospinal fluid. In contrast, all spinal defects repaired by <jats:styled-content style=\"fixed-case\">HUC<\/jats:styled-content>\u2010suture were healed with complete regrowth of epidermal, dermal and subdermal tissue components, with no exposed spinal cord. The maximal skin wound width was 21 \u00b1 3.6 mm in the <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive group but 3 \u00b1 0.8 mm in the <jats:styled-content style=\"fixed-case\">HUC<\/jats:styled-content>\u2010suture group (<jats:italic>P &lt;<\/jats:italic> 0.001). The spinal cord area (<jats:italic>P<\/jats:italic> = 0.001) and the number of anterior horn cells (<jats:italic>P<\/jats:italic> = 0.03) was preserved to a greater degree in the <jats:styled-content style=\"fixed-case\">HUC<\/jats:styled-content>\u2010suture group than in the <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive group, whilst psammoma bodies, signifying neuronal degeneration, were only observed in the <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive group. Anatomic changes, indicative of Chiari <jats:styled-content style=\"fixed-case\">II<\/jats:styled-content> malformation, were seen in all three fetuses of the <jats:styled-content style=\"fixed-case\">BCF<\/jats:styled-content>\u2010adhesive group but in none of the <jats:styled-content style=\"fixed-case\">HUC<\/jats:styled-content>\u2010suture group (<jats:italic>P &lt; <\/jats:italic>0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Cryopreserved umbilical cord graft is a promising regenerative patch for intrauterine repair of spina bifida. Copyright \u00a9 2015 ISUOG. Published by John Wiley &amp; Sons Ltd.<\/jats:p><\/jats:sec>","DOI":"10.1002\/uog.15790","type":"journal-article","created":{"date-parts":[[2015,10,22]],"date-time":"2015-10-22T08:30:16Z","timestamp":1445502616000},"page":"168-176","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Cryopreserved human umbilical cord patch for <i>in\u2010utero<\/i> spina bifida repair"],"prefix":"10.1002","volume":"47","author":[{"given":"R.","family":"Papanna","sequence":"first","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Maternal\u2010Fetal Medicine UT Health School of Medicine  Houston TX USA"},{"name":"Fetal Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"K. J.","family":"Moise","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Maternal\u2010Fetal Medicine UT Health School of Medicine  Houston TX USA"},{"name":"Fetal Center  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. K.","family":"Mann","sequence":"additional","affiliation":[{"name":"Department of Obstetrics, Gynecology and Reproductive Medicine, Division of Maternal\u2010Fetal Medicine UT Health School of Medicine  Houston TX USA"},{"name":"Department of Pathology and Laboratory Services UT Health School of Medicine  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Fletcher","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurosurgery UT Health School of Medicine  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Schniederjan","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery UT Health School of Medicine  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. B.","family":"Bhattacharjee","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery UT Health School of Medicine  Houston TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. J.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Bioengineering University of Utah  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Kaur","sequence":"additional","affiliation":[{"name":"Department of Bioengineering University of Utah  Salt Lake City UT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. P.","family":"Prabhu","sequence":"additional","affiliation":[{"name":"Department of Radiology, Harvard Medical School Boston Children's Hospital  Boston MA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S. C. G.","family":"Tseng","sequence":"additional","affiliation":[{"name":"Ocular Surface Center and TissueTech, Inc.  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