Prevention of Peritendinous Adhesions Following Flexor Tendon Injury With Seprafilm

Menderes, Adnan; Mola, Fahri; Tayfur, Volkan; Vayvada, Haluk; Barutçu, Ali

doi:10.1097/01.sap.0000134507.00053.1a

Cited by 58 publications

(43 citation statements)

References 15 publications

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“…[27][28][29] Previous investigators have also reported the effect of carbodiimide derivatized HA (cd-HA) on a tendon surface. 23,24,30 Momose et al 23 studied carbodiimide derivatized HA (1%HA-1%EDC-1.5%NHS) treated tendons in vitro, and showed a significantly lower gliding resistance compared to saline and unmodified HA-treated tendons. However, their experiment was only for 100 cycles, and their HA treatment was not mixed with gelatin.…”

Section: Discussionmentioning

confidence: 99%

Optimization of surface modifications of extrasynovial tendon to improve its gliding ability in a canine model in vitro

et al. 2006

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Previous studies have shown that the carboxyl groups in hyaluronic acid (HA) could be activated by 1-ethy 1-3-[3-dimethylaminopropyl] carbodiimide hydrochloride (EDC)/N-hydroxysuccinimide (NHS) to form intermediate O-acylisoureas, which can chemically bind to exposed amino groups on the tendon surface, leading to improved gliding ability. However, the optimal ratio and concentrations of the components in this chemical mixture were not investigated. The purpose of this study was to optimize the constituents of this tissue engineering approach to tendon surface modification, to reduce friction and improve durability. Peroneus longus (PL) tendons (n ¼ 40) were harvested from adult mongrel dogs along with the A2 pulley obtained from the ipsilateral hind paw. After the gliding resistance of the normal PL tendon was measured, the tendons were treated under varying concentrations of HA (0.5, 1, and 2%) and EDC/NHS (0.05, 0.25, and 1%) mixed with a 10% gelatin. Tendon friction was measured for 1000 cycles of simulated flexion/extension motion. Following testing, the residual HA on the tendon surface was evaluated by immunohistochemisty. The gliding resistance of the untreated PL tendons had a mean value of 0.087 AE 0.021 N. After surface treatment, there was no significant difference in friction due to HA concentration alone, but the concentration of EDC/NHS and the interaction between HA concentration and EDC/NHS concentration had a significant effect on friction. Regardless of HA concentration, the friction after 1000 cycles was significantly decreased in preparations which included a 1% concentration of EDC/ NHS. The tendons with lower gliding resistance presented a smoother surface on light microscopy and maintained more residual HA on the tendon surface. By varying the relative concentrations of HA, EDC, and NHS it is possible to optimize the effect of surface treatment on friction and durability in a canine extrasynovial tendon in vitro. ß

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Section: Discussionmentioning

confidence: 99%

Optimization of surface modifications of extrasynovial tendon to improve its gliding ability in a canine model in vitro

et al. 2006

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“…This has not found wide clinical application, however, because the material is difficult to prepare and must be sewn around the tendon repair. Merle et al [16] studied a bioresorbable gel composed of a carbohydrate polymer (ADCON-T/N). Although a decrease in tendon adhesion formation was demonstrated in an animal model, clinical trial results have been disappointing, and there is some question as to whether the material migrates from the repair site [17].…”

Section: Discussionmentioning

confidence: 99%

“…The idea of a mechanical barrier to adhesion formation is not new. In previous decades, many different materials, both biological and synthetic, have been tested [3,6,11,16,19,20,25]. Biological barriers have met with variable success and add donor site morbidity and surgical complexity to the procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Mechanical barriers like alumina sheaths, polyethylene membranes, cellophane, sterispon wrapping, stainless steel or silicone sheeting, amniotic membranes, chitosan membranes, silicone rubber envelopes, polytetrafluoroethylene surgical membranes, seprafilm, hydrogel sealant, chondritin sulphate coated polyhydroxyethyl metacrylate membrane, and autogenous vein graft may be either biological or synthetic [3,6,11,16,19,20,25]. The ideal barrier would be easy to use, biocompatible, allow tendon movement, not add undue bulk, remain at the site of repair long enough to allow tendon healing (extrinsic healing), absorbable, and cheap.…”

Section: Introductionmentioning

confidence: 99%

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A new material for prevention of peritendinous fibrotic adhesions after tendon repair: oxidised regenerated cellulose (Interceed), an absorbable adhesion barrier

Temiz

Öztürk

Bakunov

et al. 2007

International Orthopaedics (SICO

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“…Ozgenel (11) emphasized that despite the lack of difference in tendon healing, use of the amniotic membrane and hyaluronic acid combination following flexor tendon surgery was effective in preventing adhesion in a chicken model. Menderes et al (3) reported that peritendinous adhesions following flexor tendon repairs could be decreased with Seprafilm®, and collagen fibers had more organized arrangements compared with the control group. In experimental animal studies on the effects of oral glcN-CS on the rat Achilles tendon, Özer et al (16) reported less inflammation, more regularly arranged collagen formation, and significantly higher levels of tendon tensile strength associated with oral glcN-CS use.…”

Section: Features Of Adhesions (Points)mentioning

confidence: 99%

The Effect of Sodium Hyaluronate plus Sodium Chondroitin Sulfate Solution on Peritendinous Adhesion and Tendon Healing: An Experimental Study

et al. 2016

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Background: Adhesion formation following tendon injury is a serious clinical problem. Aims: In this experimental study, the effects of the combination of sodium hyaluronate (HA) and chondroitin sulfate (CS) on peritendinous adhesion and tendon healing were evaluated. Study Design: Animal experimentation. Methods: Twenty-one mature Sprague Dawley male rats were randomly divided into three equal groups. The rats' Achilles tendons were cut and repaired with a modified Kessler technique. About 0.25 and 0.50 mL of the HA and CS (HA+CS) combination were injected subcutaneously into the repair site of the rats in groups 1 and 2, respectively, on days 0, 3, 7, and 10. The subjects in group 3 were used as the control group. At 6 weeks, all rats were euthanized. The tenotomy site was examined macroscopically in all animal subjects. Four samples were assigned to the histopathological examination group, and the others were assigned to the biomechanical assessment group.Results: Inflammation and adhesion in both treatment groups were observed at a lower rate than in the control group. The collagen filaments in both treatment groups were regular and the number was low when compared to the control group. However, there was no statistically significant difference between group 1 and the control group. The quantity, quality, and grade of the adhesions were statistically significantly lower in group 2 when compared with the other groups. The mean maximum stress strength in group 2 was statistically significantly higher than that in group 1 and the control group. Conclusion: Local administration of the HA+CS combination solution is a valid tool for preventing peritendinous adhesion after extrasynovial tendon repair such as Achilles tendon, and is a treatment option in such cases.

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Prevention of Peritendinous Adhesions Following Flexor Tendon Injury With Seprafilm

Cited by 58 publications

References 15 publications

Optimization of surface modifications of extrasynovial tendon to improve its gliding ability in a canine model in vitro

Optimization of surface modifications of extrasynovial tendon to improve its gliding ability in a canine model in vitro

A new material for prevention of peritendinous fibrotic adhesions after tendon repair: oxidised regenerated cellulose (Interceed), an absorbable adhesion barrier

The Effect of Sodium Hyaluronate plus Sodium Chondroitin Sulfate Solution on Peritendinous Adhesion and Tendon Healing: An Experimental Study

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