背景:有许多粘附屏障材料,交联或非交联透明质酸(HA),在手术中使用。
目的:本研究探讨了交联和非交联HA预防跟腱粘连的疗效。我们假设非交联HA可能比交联HA更有效地预防跟腱损伤和修复后的粘连。
方法:20只雄性SD大鼠,总共40条腿,接受跟腱横断和修复。手术后,用交联和非交联HA制剂同时治疗.将大鼠分为四组:阳性对照组,一组用BMC非交联HA凝胶治疗,一组用DEFEHERE交联HA凝胶治疗,和一组用ANIKA交联HA凝胶处理。手术四周后,对肌腱周围粘连进行了宏观评估和组织学分析,以评估治疗的有效性。
结果:与交联HA和对照组相比,非交联BMCHA在预防肌腱粘连方面表现出优异的功效。组织学分析证实非交联HA组的粘连严重程度降低(P<0.05)。研究结果支持非交联HA作为抑制肌腱粘连的治疗方法的潜力。进一步研究,包括临床试验,有必要在人类受试者中验证这些结果。
结论:非交联的BMCHA与交联的HA和对照组相比,在组织学分析中具有更低的肌腱粘连参数和更好的愈合评分。非交联HA有望作为抑制此类粘连形成的潜在治疗方法。
BACKGROUND: There are many adhesion barrier materials, cross-linked or non-cross-linked hyaluronic acid (HA), used during surgeries.
OBJECTIVE: This study investigates the efficacy of cross-linked and non-cross-linked HA in preventing Achilles tendon adhesions. We hypothesized that non-cross-linked HA may be more effective than cross-linked HA in preventing Achilles tendon adhesions following injury and repair.
METHODS: Twenty male Sprague Dawley rats, totaling 40 legs, underwent Achilles tendon transection and repair. Following the surgery, they were treated simultaneously with cross-linked and non-cross-linked HA formulations. The rats were divided into four groups: a positive control group, a group treated with BMC non-cross-linked HA gel, a group treated with DEFEHERE cross-linked HA gel, and a group treated with ANIKA cross-linked HA gel. Four weeks after surgery, macroscopic evaluation of peritendinous adhesion and histological analysis were conducted to assess the effectiveness of the treatments.
RESULTS: Non-cross-linked BMC HA demonstrated superior efficacy in preventing tendon adhesions compared to cross-linked HA and control groups. Histological analysis confirmed reduced adhesion severity in the non-cross-linked HA group (P < 0.05). The findings support the potential of non-cross-linked HA as a treatment to inhibit tendon adhesions. Further research, including clinical trials, is warranted to validate these results in human subjects.
CONCLUSIONS: Non-cross-linked BMC HA had significantly lower tendon adhesions parameters and better healing scores in histological analysis than cross-linked HA and control group did. Non-cross-linked HA holds promise as a potential treatment to inhibit the formation of such adhesions.