Wichelhaus Alice, Beyersdoerfer Sascha Tobias, Vollmar Brigitte, Mittlmeier Thomas, Gierer Philip
Abteilung für Unfall-, Hand- und Wiederherstellungschirurgie, Chirurgische Universitätsklinik Rostock, Schillingallee 35, 18055 Rostock, Germany.
Rudolf-Zenker-Institut für Experimentelle Chirurgie und Zentrale Versuchstierhaltung, Universitätsmedizin Rostock, Schillingallee 69a, 18057 Rostock, Germany.
Biomed Res Int. 2016;2016:4063137. doi: 10.1155/2016/4063137. Epub 2016 Jun 30.
Introduction. This study was designed to investigate the influence of the amount of suture material on the formation of peritendinous adhesions of intrasynovial flexor tendon repairs. Materials and Methods. In 14 rabbits, the flexor tendons of the third and the fourth digit of the right hind leg were cut and repaired using a 2- or 4-strand core suture technique. The repaired tendons were harvested after three and eight weeks. The range of motion of the affected toes was measured and the tendons were processed histologically. The distance between the transected tendon ends, the changes in the peritendinous space, and cellular and extracellular inflammatory reaction were quantified by different staining. Results. A 4-strand core suture resulted in significantly less gap formation. The 2-strand core suture showed a tendency to less adhesion formation. Doubling of the intratendinous suture material was accompanied by an initial increase in leukocyte infiltration and showed a greater amount of formation of myofibroblasts. From the third to the eighth week after flexor tendon repair, both the cellular and the extracellular inflammation decreased significantly. Conclusion. A 4-strand core suture repair leads to a significantly better tendon healing process with less diastasis between the sutured tendon ends despite initially pronounced inflammatory response.
引言。本研究旨在调查缝线材料的用量对滑膜内屈肌腱修复术后腱周粘连形成的影响。材料与方法。选取14只家兔，切断并使用2股或4股核心缝合法修复右后肢第三和第四趾的屈肌腱。在术后3周和8周时取出修复后的肌腱。测量患趾的活动范围，并对肌腱进行组织学处理。通过不同染色对横断肌腱两端的距离、腱周间隙的变化以及细胞和细胞外炎症反应进行量化。结果。4股核心缝合法导致的间隙形成明显更少。2股核心缝合法显示出粘连形成较少的趋势。肌腱内缝线材料加倍伴随着白细胞浸润的最初增加，并显示出更多的肌成纤维细胞形成。在屈肌腱修复后的第3周和第8周之间，细胞和细胞外炎症均显著减轻。结论。尽管最初有明显的炎症反应，但4股核心缝合法修复导致肌腱愈合过程明显更好，缝合的肌腱两端之间的分离更少。
