Prevention of tendon adhesions by the reconstruction of the tendon sheath with solvent dehydrated bovine pericard: An experimental study.
BACKGROUND
The achievement of the kinetic functions of a finger in full range of motion after the injury and the repair of the flexor tendon has been a challenging issue in hand surgery. Several current studies emphasize the importance of the tendon sheath for the healing of the tendon and for the prevention of the adhesive bands and advise primary repair or reconstruction of them. Various biological and synthetic materials have been used for this purpose with different rates of success.


METHODS
In this experimental study, the sheaths of flexor tendons of chicken toe were excised and three groups were observed: group 1, primary sheath not repaired; group 2, sheath repair with autogenous fascia; and group 3, sheath reconstruction with solvent dehydrated bovine pericardium (SDBP).


RESULTS
Histopathologic evaluations were performed on the 3rd and 12th weeks to determine the outcome of the repair methods regarding the gliding surfaces of the tendons, adhesion rates, and inflammatory reactions, which are the main issues on the healing of the tendon. The results indicated less formation of adhesions in group 3 compared with groups 1 and 2 (p = 0.001).


CONCLUSIONS
The results showed that SDBP can be used for the reconstruction of the sheaths successively for the prevention of the adhesive bands in flexor tendon surgery.
Sungur
Nezih
N
Department of Plastic and Reconstructive Surgery, Ankara Training and Research Hospital, Ankara, Turkey. drnezihsungur@yahoo.com
Uysal
Afşin
A
Koçer
Uğur
U
Karaaslan
Onder
O
Gümüş
Murat
M
Sökmensüer
Lale Karakoç
LK
Sökmensüer
Cenk
C
D000818:Animals; D001684:Biological Dressings; D002645:Chickens; D004195:Disease Models, Animal; D005383:Finger Injuries / Q000601:surgery*; D013536:Suture Techniques; D013708:Tendon Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D000267:Tissue Adhesions / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control*; D014945:Wound Healing / Q000502:physiology