Liu Yanchun, Skardal Aleksander, Shu Xiao Zheng, Prestwich Glenn D
Center for Therapeutic Biomaterials and Department of Medicinal Chemistry, The University of Utah, 419 Wakara Way, Suite 205, Salt Lake City, Utah 84108-1257, USA.
J Orthop Res. 2008 Apr;26(4):562-9. doi: 10.1002/jor.20499.
Peritendinous adhesions are an important complication of flexor tendon injury. Three hyaluronan (HA)-derived biomaterials were evaluated for the reduction of peritendinous adhesions following partial-thickness tendon injury in rabbits. Rabbits (n = 24) were divided into three groups (n = 8 per group), which were used for gross evaluation, histologic assessment, or biomechanical testing. The fourth and third toes from both hindpaws of each rabbit were randomly assigned to one of four treatments: (i) untreated control, (ii) Seprafilm, (iii) Carbylan-SX in situ crosslinked hydrogel, and (iv) preformed Carbylan-SX film. Rabbits were sacrificed at 3 weeks postsurgery and evaluated anatomically, histologically, and mechanically. All materials used reduced adhesions relative to untreated controls for all three evaluations. Both the gross anatomic and histologic results revealed that Carbylan-SX film was statistically superior to Seprafilm and Carbylan-SX gel in preventing tendon adhesion formation. In biomechanical tests, the Carbylan-SX film-treated hindpaws required the least force to pull the tendon from the sheath. This force was statistically indistinguishable from that required to extrude an unoperated tendon (n = 8). Carbylan-SX gel was less effective than Carbylan-SX film but superior to Seprafilm for all evaluations. A crosslinked HA-derived film promoted healing of a flexor tendon injury without the formation of fibrosis at 3 weeks postoperatively.
腱周粘连是屈肌腱损伤的一种重要并发症。评估了三种透明质酸（HA）衍生的生物材料在兔部分厚度肌腱损伤后减少腱周粘连的效果。将24只兔分为三组（每组8只），分别用于大体评估、组织学评估或生物力学测试。将每只兔双后足的第四和第三趾随机分配至四种处理之一：（i）未处理对照，（ii）施沛特，（iii）原位交联的卡比兰-SX水凝胶，和（iv）预制的卡比兰-SX膜。术后3周处死兔，并进行解剖学、组织学和力学评估。在所有三项评估中，相对于未处理对照，所有使用的材料均减少了粘连。大体解剖和组织学结果均显示，在预防肌腱粘连形成方面，卡比兰-SX膜在统计学上优于施沛特和卡比兰-SX凝胶。在生物力学测试中，经卡比兰-SX膜处理的后足将肌腱从腱鞘中拉出所需的力最小。该力在统计学上与拉出未手术肌腱所需的力无差异（n = 8）。在所有评估中，卡比兰-SX凝胶的效果不如卡比兰-SX膜，但优于施沛特。一种交联的HA衍生膜在术后3周促进了屈肌腱损伤的愈合，且未形成纤维化。
