Effects of Hyalobarrier gel and Seprafilm in preventing peritendinous adhesions following crush-type injury in a rat model

BACKGROUND: In the present study, the aim was to evaluate the effects of Hyalobarrier gel (Anika Therapeutics S.r.l., Abano Terme, Italy) and Seprafilm adhesion barrier (Genzyme Corporation, Cambridge, MA, USA) in the prevention of peritendinous adhesions following a crush-type injury.
METHODS: Twenty five female Wistar Albino rats, weighing 230 to 270 g and 7 to 9 months of age were randomized into 5 groups. Group 1 was the control group, Group 2 comprised the Hyalobarrier gel group, Group 3 was made up of the Seprafilm-treated subjects, Group 4 was the tendon repair and Hyalobarrier gel group, and Group 5 was the tendon repair and Seprafilm group. Two gastrocnemius muscle tendons of each animal, a total of 50 tendons, were used. The animals were sacrificed with the administration of a high dose of anesthetic on postoperative day 40. Macroscopic evaluation of adhesions was classified by 2 blinded researchers according to Tang’s adhesion grading system. The number of fibroblasts and the density and formation of collagen fibers were noted for histopathological examination.
RESULTS: None of the subjects in Group 2 was determined to have a severe adhesion, and moderate or severe adhesions were detected in Groups 3, 4, and 5. There was no statistically significant difference between Group 2 and the control group (p=0.737). Groups 3, 4, and 5 demonstrated fewer adhesions than Groups 1 and 2 (p<0.05). Groups 4 and 5 had fewer adhesions than Groups 2 and 3 (p<0.05). There was no statistically significant difference between Groups 4 and 3 (p=0.342). The histopathological findings were consistent with the macroscopic findings.
CONCLUSION: Seprafilm was found to be effective in the prevention of peritendinous adhesions following a crush-type injury with or without repair of the tendon fibers. In contrast, Hyalobarrier gel was found to be effective only following repair of the tendon fibers.

Sýçan modelinde ezilme tipi yaralanma sonrasýnda geliþen tendon yapýþýklýklarýnýn önlenmesinde Hyalobarrier Gel ve Seprafilm’in etkinliði

AMAÇ: Çalýþmamýzda Hyalobarrier Gel ve Seprafilm’in ezilme tipi yaralanma sonrasýnda tendon yapýþýklýklarýnýn önlenmesi üzerindeki etkisini deðerlendirmeyi amaçladýk.
GEREÇ VE YÖNTEM: Yirmi beþ adet 230–270 gram aralýðýnda ve yedi–dokuz aylýk diþi sýçanlar beþ grup olarak randomize edildi. Grup 1: Kontrol grubu, Grup 2: Hyalobarrier Gel grubu, Grup 3: Seprafilm grubu, Grup 4: Tendon onarýmý ve Hyalobarrier Gel grubu, Grup 5: Tendon onarýmý ve Seprafilm grubu olarak adlandýrýldý. Her deney hayvanýnýn iki gastroknemius kasý tendonu olmak üzere toplamda 50 tendon kullanýldý. Deney hayvanlarý yüksek doz anestezi uygulamasýyla operasyon sonrasý 40. günde sakrifiye edildiler. Yapýþýklýklarýn makroskopik deðerlendirilmesi iki kör araþtýrmacý tarafýndan Tang’ýn yapýþýklýk dereceleme sistemiyle sýnýflandýrýldý. Histopatolojik deðerlendirme için fibroblast sayýlarý, kollajen yoðunluðu ve yapýsý deðerlendirmeye alýndý.
BULGULAR: Grup 2’de ciddi yapýþýklýk saptanmadý; Grup 3, 4 ve 5’te orta ve ciddi yapýþýklýk saptanmadý. Grup 2 ve kontrol grubu arasýnda istatistiksel açýdan anlamlý fark bulunmadý (p=0.737). Grup 3, 4 ve 5; Grup 1 ve 2’den daha az yapýþýklýða sahipti (p<0.05). Grup 4 ve 5 sýrasýyla Grup 2 ve 3’ten daha az yapýþýklýða sahipti (p<0.05). Grup 3 ve 4 arasýnda istatistiksel açýdan anlamlý fark bulunmadý (p=0.342). Histopatolojik bulgular da makroskopik bulgulara paraleldi.
TARTIÞMA: Seprafilm, ezilme tipi yaralanmayý takiben tendon yapýþýklýklarýný önlemede, tendon tamiri yapýlan ve yapýlmayan her iki grupta etkili bulundu. Buna karþýlýk Hyalobarrier Gel’in sadece tendon tamiri yapýlan grupta yapýþýklýðý önlemede etkili olduðu saptandý.