Ni Tao, Senthil-Kumar Prabhu, Dubbin Karen, Aznar-Cervantes Salvador D, Datta Néha, Randolph Mark A, Cenis José L, Rutledge Gregory C, Kochevar Irene E, Redmond Robert W
Department of Burns and Plastic Surgery, No. 3 People's Hospital, and Institute of Traumatic Medicine; School of Medicine, Shanghai Jiao Tong University, Shanghai 201900, P.R. China.
Lasers Surg Med. 2012 Oct;44(8):645-52. doi: 10.1002/lsm.22066. Epub 2012 Aug 21.
Suture repair of Achilles tendon rupture can cause infection, inflammation and scarring, while prolonged immobilization promotes adhesions to surrounding tissues and joint stiffness. Early mobilization can reduce complications provided the repair is strong enough to resist re-rupture. We have developed a biocompatible, photoactivated tendon wrap from electrospun silk (ES) to provide additional strength to the repair that could permit early mobilization, and act as a barrier to adhesion formation.
STUDY DESIGN/MATERIAL AND METHODS: ES nanofiber mats were prepared by electrospinning. New Zealand white rabbits underwent surgical transection of the Achilles tendon and repair by: (a) SR: standard Kessler suture + epitendinous suture (5-0 vicryl). (b) ES/PTB: a single stay suture and a section of ES mat, stained with 0.1% Rose Bengal (RB), wrapped around the tendon and bonded with 532 nm light (0.3 W/cm(2) , 125 J/cm(2) ). (c) SR + ES/PTB: a combination of (a) and (b). Gross appearance, extent of adhesion formation and biomechanical properties of the repaired tendon were evaluated at Days 7, 14, or 28 post-operatively (n = 8 per group at each time point).
Ultimate stress (US) and Young's modulus (E) in the SR group were not significantly different from the ES/PTB group at Days 7 (US, P = 0.85; E, P = 1), 14 (US, P = 0.054; E, P = 1), and 28 (US, P = 0.198; E, P = 0.12) post-operatively. Adhesions were considerably greater in the SR group compared to the ES/PTB group at Days 7 (P = 0.002), 14 (P < 0.0001), and 28 (P < 0.0001). The combination approach of SR + ES/PTB gave the best outcomes in terms of E at 7 (P < 0.016) and 14 days (P < 0.016) and reduced adhesions compared to SR at 7 (P < 0.0001) and 14 days (P < 0.0001), the latter suggesting a barrier function for the photobonded ES wrap.
Photochemical sealing of a ES mat around the tendon repair site provides considerable benefit in Achilles tendon repair. Lasers Surg. Med. 44: 645-652, 2012. © 2012 Wiley Periodicals, Inc.
跟腱断裂的缝合修复可能会导致感染、炎症和瘢痕形成，而长期固定会促使与周围组织粘连并导致关节僵硬。如果修复足够牢固以抵抗再次断裂，早期活动可以减少并发症。我们已开发出一种由电纺丝（ES）制成的生物相容性光活化肌腱包裹物，为修复提供额外强度，从而允许早期活动，并作为粘连形成的屏障。
研究设计/材料与方法：通过静电纺丝制备ES纳米纤维垫。对新西兰白兔进行跟腱手术横断并采用以下方法修复：（a）SR：标准凯斯勒缝合+腱周缝合（5-0爱惜康缝线）。（b）ES/PTB：一根单根支撑缝线和一段ES垫，用0.1%孟加拉玫瑰红（RB）染色，包裹在肌腱周围并用532nm光（0.3W/cm²，125J/cm²）粘结。（c）SR+ES/PTB：（a）和（b）的联合方法。在术后第7、14或28天评估修复肌腱的大体外观、粘连形成程度和生物力学性能（每个时间点每组n = 8）。
术后第7天（极限应力，P = 0.85；杨氏模量，P = 1）、14天（极限应力，P = 0.054；杨氏模量，P = 1）和28天（极限应力，P = 0.198；杨氏模量，P = 0.12），SR组的极限应力（US）和杨氏模量（E）与ES/PTB组无显著差异。在第7天（P = 0.002）、14天（P < 0.0001）和28天（P <
