title: The use of a hydrogel sealant on flexor tendon repairs to prevent adhesion formation.
abstract: The prevention of peritendinous adhesions after zone II flexor tendon repair poses a significant challenge to hand surgeons. This study evaluates a hydrogel sealant (FocalSeal-L) as a barrier to peritendinous adhesion formation. The deep flexors of toes 2 through 4 were divided and repaired in 30 chickens. Chickens were randomized to tendon repair with (n = 15) or without (n = 15) FocalSeal-L. Each group was further randomized to have their tendons studied postoperatively at 3 (n = 10), 6 (n = 10), or 12 (n = 10) weeks. Histologic evaluation revealed decreased peritendinous adhesion formation in the FocalSeal-L group. Biomechanical analysis demonstrated a decrease in work of flexion in the FocalSeal-L group that was most pronounced at 6 weeks (P = 0.0020). There was no significant difference in breaking strength. Apparently, an effective barrier to peritendinous adhesion formation, this sealant system is easy to use, biocompatible, and bioresorbable. In addition, it is not bulky or restrictive to tendon glide.
authors.affiliation: Division of Plastic Surgery, University of Kentucky College of Medicine, Lexington, Kentucky, USA. dr.rob@uky.edu
authors.forename: Robert E H
authors.initials: RE
authors.lastname: Ferguson
authors.forename: Brian
authors.initials: B
authors.lastname: Rinker
mesh_terms: D000818:Animals; D002645:Chickens; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D011897:Random Allocation; D013708:Tendon Injuries / Q000601:surgery*; D000267:Tissue Adhesions / Q000517:prevention & control
chemical_list: D015718:Fibrin Tissue Adhesive; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate