Prevention of Peritendinous Adhesions Using an Electrospun DegraPol Polymer Tube : A Histological, Ultrasonographic, and Biomechanical Study in Rabbits

Abstract EN

Purpose.

One of the great challenges in surgical tendon rupture repair is to minimize peritendinous adhesions.

In order to reduce adhesion formation, a physical barrier was applied to a sutured rabbit Achilles tendon, with two different immobilization protocols used postoperatively.

Methods.

Thirty New Zealand white rabbits received a laceration on the Achilles tendon, sutured with a 4-strand Becker suture, and half of the rabbits got a DegraPol tube at the repair site.

While fifteen rabbits had their treated hind leg in a 180° stretched position during 6 weeks (adhesion provoking immobilization), the other fifteen rabbits were recasted with a 150° position after 3 weeks (adhesion inhibiting immobilization).

Adhesion extent was analysed macroscopically, via ultrasound and histology.

Inflammation was determined histologically.

Biomechanical properties were analysed.

Results.

Application of a DegraPol tube reduced adhesion formation by approximately 20%—independently of the immobilization protocol.

Biomechanical properties of extracted specimen were not affected by the tube application.

There was no serious inflammatory reaction towards the implant material.

Conclusions.

Implantation of a DegraPol tube tightly set around a sutured tendon acts as a beneficial physical barrier and prevents adhesion formation significantly—without affecting the tendon healing process.