title: Role of anti-adhesive barriers following rotator cuff repair surgery: an experimental study.
abstract: OBJECTIVE
  This experimental study investigates the effectiveness of expanded polytetrafluoroethylene (Dualmesh®, Gore Medical, Flagstaff, AZ, USA), sodium hyaluronate-carboxymethyl cellulose (Seprafilm®, Genzyme, Cambridge, MA, USA), and polysiloxane (silicone) as anti-adhesive barriers for inhibition of fibrosis in the subacromial area following rotator cuff repair.
  
  
  METHODS
  Rabbit rotator cuff tenotomy and repair was conducted on 24 rabbits in 4 groups: control (Group A), Dualmesh® (Group B), Seprafilm® (Group C), and silicone (Group D). Anti-adhesive barrier materials were sutured over the repaired rotator cuff. Macroscopic and histological evaluations were made at the end of the sixth postoperative week.
  
  
  RESULTS
  Macroscopic evaluation revealed that minimal adhesion occurred in the control and silicone groups, while the Seprafilm® and Dualmesh® groups showed evidence of fibrosis. Microscopic evaluation revealed diffuse fibrosis and collagen accumulation in the Dualmesh® and Seprafilm® groups, whereas minimal collagen deposition and inflammatory cell reaction was found among the silicone and control groups. Significant differences were found between the silicone and Dualmesh® (p=0.001) and silicone and Seprafilm® groups (p=0.002), as well as between the control and Dualmesh® (p=0.002) and control and Seprafilm® groups (p=0.002).
  
  
  CONCLUSIONS
  Expanded polytetrafluoroethylene (ePTFE/Dualmesh®) and sodium hyaluronate carboxymethyl cellulose (SH-CMC/Seprafilm®) did not prevent or attenuate postoperative subacromial fibrosis following cuff tear repair. Nor did silicone prevent or attenuate fibrosis. More detailed research is needed for development of an effective anti-adhesive barrier for use after rotator cuff tear surgery.
authors.affiliation: Ankara University Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey.
authors.forename: Mahmut
authors.initials: M
authors.lastname: Kalem
authors.affiliation: Bülent Ecevit University Faculty of Medicine, Department of Orthopedics and Traumatology, Zonguldak, Turkey.
authors.forename: Ercan
authors.initials: E
authors.lastname: Şahin
authors.affiliation: Bülent Ecevit University Faculty of Medicine, Department of Orthopedics and Traumatology, Zonguldak, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Songür
authors.affiliation: Hitit University Faculty of Medicine, Department of Orthopedics and Traumatology, Çorum, Turkey.
authors.forename: Sinan
authors.initials: S
authors.lastname: Zehir
authors.affiliation: Ankara University Faculty of Medicine, Department of Orthopaedics and Traumatology, Ankara, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Armangil
authors.affiliation: Memorial Hospital, Department of Orthopedics and Traumatology, Ankara, Turkey.
authors.forename: Mehmet A
authors.initials: MA
authors.lastname: Demirtaş
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005355:Fibrosis / Q000517:prevention & control; D006820:Hyaluronic Acid / Q000494:pharmacology*; D011138:Polytetrafluoroethylene / Q000494:pharmacology*; D011183:Postoperative Complications / Q000517:prevention & control*; D011817:Rabbits; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D012828:Silicones / Q000494:pharmacology*; D013710:Tendons / Q000473:pathology; D058971:Tenotomy / Q000009:adverse effects*; D000267:Tissue Adhesions / Q000517:prevention & control*
chemical_list: C118198:Seprafilm; D012828:Silicones; D011138:Polytetrafluoroethylene; D006820:Hyaluronic Acid