Güdemez Eftal, Ekşioğlu Fatih, Korkusuz Petek, Aşan Esin, Gürsel Ihsan, Hasirci Vasif
Department of Orthopaedic Surgery and Traumatology, Kirikkale University School of Medicine, Kirikkale, Turkey.
J Hand Surg Am. 2002 Mar;27(2):293-306. doi: 10.1053/jhsu.2002.31161.
Polyhydroxyethyl methacrylate (pHEMA) membranes coated on one side with chondroitin sulfate (CS) were used to block adhesion physically and to reduce friction between healing flexor tendons and the surrounding tissue in rabbit forepaws after surgical repair. Digits with pHEMA-only, standard tendon sheath repair, and with no sheath repair were the controls. Over 12 weeks the CS-coated membranes were evaluated for joint flexion, adhesion limitation, and tendon healing progress. The membranes initially allowed for better flexion (ie, for 6 weeks), but their relative superior effectiveness faded afterward. Histology showed that adhesions were less severe and healing was better in the CS-pHEMA membranes at 3 and 6 weeks. If further studies determine precise amounts or thicknesses of CS coats that will maximize its healing properties, CS-pHEMA should prove useful in clinical settings in which restoration of tendon sheath integrity with a minimum of adhesions is not possible.
一侧涂有硫酸软骨素（CS）的聚甲基丙烯酸羟乙酯（pHEMA）膜被用于在手术修复后物理性地阻止兔前爪愈合中的屈肌腱与周围组织之间的粘连并减少摩擦。仅使用pHEMA、进行标准腱鞘修复以及不进行腱鞘修复的趾作为对照。在12周的时间里，对涂有CS的膜进行关节屈曲、粘连限制和肌腱愈合进展方面的评估。这些膜最初能实现更好的屈曲（即持续6周），但其相对卓越的有效性随后逐渐消失。组织学显示，在3周和6周时，CS-pHEMA膜中的粘连不太严重且愈合情况更好。如果进一步的研究确定能使CS涂层的愈合特性最大化的精确用量或厚度，那么CS-pHEMA在无法以最少粘连恢复腱鞘完整性的临床环境中应会证明是有用的。
