A novel biomimetic material for engineering postsurgical adhesion using the injured digital flexor tendon-synovial complex as an in vivo model

Olivier A. Branford, Vivek Mudera, Robert A. Brown, Duncan A. McGrouther, Adriaan O. Grobbelaar

    Research output: Contribution to journalArticlepeer-review

    Abstract

    BACKGROUND: Many surgical procedures are complicated by adhesions. These restrictive fibrotic bands form between normally separate gliding tissue layers, potentially impairing function. The authors tested the adhesion-modifying effect of a novel fibronectin-derived biomimetic biomaterial in a tendon-synovial complex injury model. METHODS: The deep flexor tendons of digits 2 and 4 in the right forepaw of 15 New Zealand White rabbits were subjected to 5-mm-long partial tenotomies. Animals were randomized to receive biomaterial tubes enveloping the tendon injuries or left untreated. Digits, amputated at 2 weeks, were randomized to mechanical pullout assessments of adhesion strength or to quantitative histologic cellularity and immunohistochemical proliferation (Ki67) assessments. RESULTS: The mean peak pullout force required to break the adhesions was reduced from 7.70 N (n = 6) in untreated digits to 0.31 N (n = 7) in biomaterial-treated digits (p = 0.001). The mean structural stiffness of the adhesions was also significantly reduced (p = 0.001). Histologically, treated and untreated digits demonstrated an equal incidence of adhesions. The treated adhesions were 55 percent less cellular at their surface than the untreated injured controls (p = 0.003). Treated tendons were 8 percent more cellular (with equal numbers of proliferating cells) at their surface and significantly more cellular within their bulk than positive controls (p ≤ 0.05). CONCLUSION: This study suggests a significant reduction in the restrictive nature of postsurgical adhesions following treatment with the antiadhesive biomaterial without compromising tendon cellularity. ©2008American Society of Plastic Surgeons.
    Original languageEnglish
    Pages (from-to)781-793
    Number of pages12
    JournalPlastic and Reconstructive Surgery
    Volume121
    Issue number3
    DOIs
    Publication statusPublished - Mar 2008

    Keywords

    • Animals
    • Biomimetic Materials
    • Disease Models, Animal
    • Fibronectins
    • Forelimb
    • adverse effects: Orthopedic Procedures
    • Rabbits
    • complications: Tendon Injuries
    • surgery: Tendons
    • Tensile Strength
    • etiology: Tissue Adhesions

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