Table 2 Comparison of advantages and disadvantages among the different methods of Amnio-M sterilization and preparation

Sterilization technique

Boiling

Cheap and liable method

Shrinkage and disruption of the membrane

[9]

Autoclave

Safe, effective, and low cost

[9]

Peracetic acid

Retaining more Collagen types I and III than gamma radiation

[142]

Irradiation

No effect on the biological and physical properties of the Amnio-M

Lessening of growth factors content

[141, 186]

Storage for up to 5 years

[187]

Preparation technique

Fresh frozen

Membrane stability

Low EGF content

High degradation rate

[145]

Drying

Membrane stability similar to fresh frozen, higher EGF content

Collagen -VII and laminins were not detected compared to cryopreserved

[145, 188]

Cryopreservation

Maintaining the integrity of the ECM high bFGF content

Cell viability and growth factors decreased after 6 months of storage

[143]

Lyophilization

Retained the biological, physical, and histological properties similar to cryopreservation

TGF-β and bFGF levels lower than fresh

[144]

Due to the irradiation process

[187]

Decellularization + lyophilization

Maintained type IV and type V collagen, elastin and laminin

Higher mechanical properties compared to fresh

Thinner membrane compared to fresh

[189]

Amnio-M sponge

3D Scaffold that can fill the tissue gab

TGF-β and bFGF levels lower than lyophilized membrane

[187]

Amnion cytokine extract

Facilitate application as it can be injectable or applied as an eye drop

[146]

Gel form

Collagen with high hydrophilicity, biocompatibility, and induced cartilage formation

[149]