Prevention of restrictive adhesions with expanded polytetrafluoroethylene diffusible membrane following flexor tendon repair: an experimental study in rabbits.

Adhesion formation constitutes a major problem following flexor tendon surgery in zone II. Expanded polytetrafluoroethylene (e-PTFE), a diffusible and biocompatible synthetic membrane, was investigated in rabbits with regard to the prevention of adhesion formation following tendon repair in zone II. An experimental model for biomechanical assessment of maximum tensile load to flex the distal interphalangeal joint 50 degrees from its resting position (MTL50) was used to estimate adhesion formation at intervals through 12 weeks. Tensile strength of the tendon repair was measured as well. On gross inspection, no apparent adverse tissue reactions or disruptions were observed. The e-PTFE group showed significantly lower MTL50 during the first 6 weeks after surgery, indicating less formation of restrictive adhesions compared with the control group. Tensile strength of tendon repair was similar in the 2 groups. Our results indicate that the e-PTFE membrane may be used as an adjunct to achieve more consistently reproducible results during the first 6 weeks following flexor tendon repair in zone II.