Amiel D, Ishizue K, Billings E, Wiig M, Vande Berg J, Akeson W H, Gelberman R
University of California, San Diego, La Jolla 92093.
J Hand Surg Am. 1989 Sep;14(5):837-43. doi: 10.1016/s0363-5023(89)80085-1.
This study assesses the effect of a preparation of hyaluronan (hyaluronic acid) applied topically at the time of flexor tendon repair in a well-established model. The hypothesis is that hyaluronic acid applied topically at the time of flexor tendon repair will decrease adhesions, and will improve clinically the gliding function of the repaired flexor tendon. After transection and repair of the second and fifth flexor tendons of the left forepaw of four mongrel dogs, the second flexor tendon was treated with hyaluronic acid of molecular weight 3.6 x 10(6) daltons applied topically between the synovial sheath and the repair site. The left forepaws were completely immobilized for 5 weeks to optimize the formation of adhesion ingrowth. After death, the repaired tendons and sheaths were removed en bloc, fixed, and dissected. Gross inspection and histologic evaluation of all tendons showed that the quality and quantity of adhesions from the wound repair to the synovial sheath appeared to have been consistently affected by hyaluronan. Hyaluronic acid had a beneficial effect on both the repair site and synovial sheath by decreasing the peripheral inflammatory response and promoting a contact healing process via epitenon and endotenon cell involvement in the repair process.
本研究在一个成熟的模型中评估了在屈指肌腱修复时局部应用透明质酸制剂的效果。假设是在屈指肌腱修复时局部应用透明质酸将减少粘连，并在临床上改善修复后的屈指肌腱的滑动功能。在对4只杂种犬左前爪的第二和第五屈指肌腱进行横断和修复后，第二屈指肌腱用分子量为3.6×10(6)道尔顿的透明质酸局部应用于滑膜鞘和修复部位之间。左前爪完全固定5周以优化粘连向内生长的形成。处死动物后，将修复的肌腱和腱鞘整块取出，固定并解剖。对所有肌腱的大体检查和组织学评估表明，从伤口修复到滑膜鞘的粘连的质量和数量似乎一直受到透明质酸的影响。透明质酸通过减少外周炎症反应并通过腱表和腱内膜细胞参与修复过程促进接触愈合过程，对修复部位和滑膜鞘均有有益作用。
