Plastic Surgery Research, University of Manchester, Manchester, United Kingdom.
Matrix Biol. 2010 Jul;29(6):525-36. doi: 10.1016/j.matbio.2010.06.002. Epub 2010 Jun 21.
Trauma by suturing tendon form areas devoid of cells termed "acellular zones" in the matrix. This study aimed to characterise the cellular insult of suturing and acellular zone formation in mouse tendon. Acellular zone formation was evaluated using single grasping sutures placed using flexor tendons with time lapse cell viability imaging for a period of 12h. Both tension and injury were required to induce cell death and cell movement in the formation of the acellular zone. DNA fragmentation studies and transmission electron microscopy indicated that cells necrosed. Parallel in vivo studies showed that cell-to-cell contacts were disrupted following grasping by the suture in tensioned tendon. Without tension, cell death was lessened and cell-to-cell contacts remained intact. Quantitative immunohistochemistry and 3D cellular profile mapping of wound healing markers over a one year time course showed that acellular zones arise rapidly and showed no evidence of healing whilst the wound healing response occurred in the surrounding tissues. The acellular zones were also evident in a standard modified "Kessler" clinical repair. In conclusion, the suture repair of injured tendons produces acellular zones, which may potentially cause early tendon failure.
缝合肌腱会在基质中的无细胞区域（称为“无细胞区”）造成创伤。本研究旨在研究缝合和无细胞区形成对小鼠肌腱的细胞损伤。使用延时细胞活力成像，通过单次抓握缝合线在屈肌腱上放置，评估无细胞区的形成，持续 12 小时。张力和损伤都需要诱导细胞死亡和细胞在无细胞区形成中的运动。DNA 片段化研究和透射电子显微镜表明细胞发生了坏死。平行的体内研究表明，在张力下，缝合线抓握后细胞间连接被破坏。没有张力时，细胞死亡减少，细胞间连接保持完整。在一年的时间内，对伤口愈合标志物的定量免疫组织化学和 3D 细胞轮廓映射显示，无细胞区迅速出现，并且没有愈合的迹象，而伤口愈合反应发生在周围组织中。在标准改良的“Kessler”临床修复中也可以看到无细胞区。总之，受伤肌腱的缝合修复会产生无细胞区，这可能会导致早期肌腱失效。
