EXPERIMENTAL STUDY ON HUMAN AMNIOTIC MEMBRANE FOR REPAIRING TENDON SHEATH DEFECT_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

GAO Ming , ZHAO Hongfang , TIAN Dehu , YU Kunlun , BAI Jiangbo , DONG Ruiyi , ZHANG Guohui.

Department of Hand Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang Hebei, 050031, P.R.China. Corresponding author: TIAN Dehu, E-mail: tiandehu899@sohu.com;

Corresponding author：

Keywords：

Amniotic membrane; Tendon sheath repair; Tendon adhesion; Chicken

DOI：

10.7507/1002-1892.20130077

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Objective To investigate the feasibility and effect of human amniotic membrane in prevention of tendon adhension after tendon sheat defect repair. Methods The amniotic membrane in size of 1.5 cm × 1.0 cm was harvested from human placenta which was voluntary donated from maternal after cesarean. Forty healthy male Leghorn chicken (aged 3-6 months) were selected, weighing (1.86 ± 0.04) kg. The model of flexor digitorum profundus tendon and tendon sheath defects was established at the third toe. After repair of the flexor digitorum profundus tendon, the human amniotic membrane was used to repair the tendon sheath defect in the right foot (group A), but tendon sheath defect was not repaired in the left foot (group B) . At 1, 2, 4, and 6 weeks after operation, the gross and histological observations were done; the degree of tendon adhesions was graded according to Tang’s tendon adhesion general observation grading standards; and the biomechanical properties (tendon slip length and total flexion angle) were tested. Results All animals survived after operation and incisions healed. Gross and histological observations showed that the new tendon sheath formed with time passing after operation in groups A and B; new tendon sheath was more maturer and smoother in group A than in group B. The degree of tendon adhesions in group A was significantly less than that in group B (P lt; 0.05) at 1 and 6 weeks after operation. The biomechanical test results showed there was no significant difference in the tendon slip length between 2 groups at 1 and 2 weeks after operation (P gt; 0.05), but the tendon slip length of group A was significantly longer than that of group B at 4 and 6 weeks after operation (P lt; 0.05). The total flexion angle of group A was significantly smaller than that of group B at 1, 2, 4, and 6 weeks after operation (P lt; 0.05). Conclusion It is effective in the prevention of tendon adhesion to use the amniotic membrane for repairing the tendon sheath defect, which is beneficial to recovery of the tendon sliding function.

Citation： GAO Ming,ZHAO Hongfang,TIAN Dehu,YU Kunlun,BAI Jiangbo,DONG Ruiyi,ZHANG Guohui.. EXPERIMENTAL STUDY ON HUMAN AMNIOTIC MEMBRANE FOR REPAIRING TENDON SHEATH DEFECT. Chinese Journal of Reparative and Reconstructive Surgery, 2013, 27(3): 335-339. doi: 10.7507/1002-1892.20130077 Copy

1.	Khanna A, Friel M, Gougoulias N, et al. Prevention of adhesions in surgery of the flexor tendons of the hand: what is the evidence? Br Med Bull, 2009, 90: 85-109.
2.	郭效朋, 沈尊理. 屏障材料预防肌腱粘连的研究进展. 现代生物医学进展杂志, 2011, 11(16): 3179-3182.
3.	Tang JB, Ishii S, Usui M, et al. Dorsal and circumferential sheath reconstructions for flexor sheath defect with concomitant bony injury. J Hand Surg (Am), 1994, 19(1): 61-69.
4.	Atik B, Tan O, Dogan A, et al. A new method in tendon repair: angular technique ofinterlocking (ATIK). Ann Hast Surg, 2008, 60(3): 251-253.
5.	郝鹏, 项舟, 罗静聪, 等. 脱细胞羊膜预防生物衍生肌腱修复鸡屈趾肌腱Ⅱ区缺损修复后的粘连. 中国组织工程研究与临床康复, 2011, 15(34): 6355-6359.
6.	Niknejad H, Peirovi H, Jorjani M, et al. Properties of the amniotic membrane for potential use in tissue engineering. Eur Cell Mater, 2008, 15: 88-99.
7.	Elkon O, Rank F. Experimental restoration of the digital synovial sheath. Scand J Plast Resconstr Surg, 1997, 11(3): 213-218.
8.	阎道海, 石秀玲, 刘前进, 等. 自体静脉移植重建腱鞘防止肌腱粘连. 中国修复重建外科杂志, 1997, 11(1): 38-39.
9.	韩文冬, 张强. 自体脂肪颗粒纯化移植预防肌腱粘连的临床研究. 实用骨科杂志, 2006, 12(6): 509-511.
10.	Karabagli Y, Ercel C, Köse AA, et al. Preventive effects of a turnover flexor tendon sheath flap on adhesion formation after flexor profundus tendon injury: an experimental study. J Plast Reconstr Aesthet Surg, 2008, 61(2): 150-157.
11.	Xu L, Cao D, Liu W, et al. In vivo engineering of a functional tendon sheath in a hen model. Biomaterials, 2010, 31(14): 3894-3902.
12.	徐梁, 曹德君, 刘伟, 等. 体内构建组织工程腱鞘的初步研究. 组织工程与重建外科杂志, 2008, 4(6): 308-311.
13.	Riccio M, Battiston B, Pajardi G, et al. Efficiency of Hyaloglide in the prevention of the recurrence of adhesions after tenolysis of flexor tendons in zone II: a randomized, controlled, multicentre clinical trial. J Hand Surg (Eur Vol), 2010, 35(2): 130-138.
14.	Suekow MA, Hodde JP, Woher WR, et al. Repair of experimental achilles tenotomy with porcine renal capsule material in a rat model. J Mater Sci Mater Med, 2007, 18(6): 1105-1110.
15.	张振才, 高文红, 胡海涛, 等. 新鲜羊膜联合自体角膜缘干细胞、唇黏膜移植治疗重度眼睑球粘连. 江苏医药, 2009, 35(9): 1078-1079.
16.	张静慧, 张丽萍, 葛志红, 等. 羊膜移植治疗睑球粘连36例临床分析. 中华实用诊断与治疗杂志, 2009, 23(10): 1020-1021.
17.	冯勇刚, 俞海安, 朱鹃芬. 人工生物羊膜贴敷治疗鼻腔粘连的疗效观察. 临床耳鼻咽喉头颈外科杂志, 2010, 24(2): 77-78.
18.	范伟杰, 杨志明, 邓力, 等. 羊膜的基础和临床应用研究进展. 中国修复重建外科杂志, 2006, 20(1): 65-68.
19.	Solomon A, Wajngarten M, Alviano F, et al. Suppression of inflammatory and fibrotic responses in allergic inflammation by the amniotic membrane stromal matrix. Clin Exp Allergy, 2005, 35(7) : 941-948.
20.	罗静聪, 李秀群, 杨志明, 等. 脱细胞羊膜的制备及其生物相容性研究. 中国修复重建外科杂志, 2004, 18(2): 108-111.

1. Khanna A, Friel M, Gougoulias N, et al. Prevention of adhesions in surgery of the flexor tendons of the hand: what is the evidence? Br Med Bull, 2009, 90: 85-109.
2. 郭效朋, 沈尊理. 屏障材料预防肌腱粘连的研究进展. 现代生物医学进展杂志, 2011, 11(16): 3179-3182.
3. Tang JB, Ishii S, Usui M, et al. Dorsal and circumferential sheath reconstructions for flexor sheath defect with concomitant bony injury. J Hand Surg (Am), 1994, 19(1): 61-69.
4. Atik B, Tan O, Dogan A, et al. A new method in tendon repair: angular technique ofinterlocking (ATIK). Ann Hast Surg, 2008, 60(3): 251-253.
5. 郝鹏, 项舟, 罗静聪, 等. 脱细胞羊膜预防生物衍生肌腱修复鸡屈趾肌腱Ⅱ区缺损修复后的粘连. 中国组织工程研究与临床康复, 2011, 15(34): 6355-6359.
6. Niknejad H, Peirovi H, Jorjani M, et al. Properties of the amniotic membrane for potential use in tissue engineering. Eur Cell Mater, 2008, 15: 88-99.
7. Elkon O, Rank F. Experimental restoration of the digital synovial sheath. Scand J Plast Resconstr Surg, 1997, 11(3): 213-218.
8. 阎道海, 石秀玲, 刘前进, 等. 自体静脉移植重建腱鞘防止肌腱粘连. 中国修复重建外科杂志, 1997, 11(1): 38-39.
9. 韩文冬, 张强. 自体脂肪颗粒纯化移植预防肌腱粘连的临床研究. 实用骨科杂志, 2006, 12(6): 509-511.
10. Karabagli Y, Ercel C, Köse AA, et al. Preventive effects of a turnover flexor tendon sheath flap on adhesion formation after flexor profundus tendon injury: an experimental study. J Plast Reconstr Aesthet Surg, 2008, 61(2): 150-157.
11. Xu L, Cao D, Liu W, et al. In vivo engineering of a functional tendon sheath in a hen model. Biomaterials, 2010, 31(14): 3894-3902.
12. 徐梁, 曹德君, 刘伟, 等. 体内构建组织工程腱鞘的初步研究. 组织工程与重建外科杂志, 2008, 4(6): 308-311.
13. Riccio M, Battiston B, Pajardi G, et al. Efficiency of Hyaloglide in the prevention of the recurrence of adhesions after tenolysis of flexor tendons in zone II: a randomized, controlled, multicentre clinical trial. J Hand Surg (Eur Vol), 2010, 35(2): 130-138.
14. Suekow MA, Hodde JP, Woher WR, et al. Repair of experimental achilles tenotomy with porcine renal capsule material in a rat model. J Mater Sci Mater Med, 2007, 18(6): 1105-1110.
15. 张振才, 高文红, 胡海涛, 等. 新鲜羊膜联合自体角膜缘干细胞、唇黏膜移植治疗重度眼睑球粘连. 江苏医药, 2009, 35(9): 1078-1079.
16. 张静慧, 张丽萍, 葛志红, 等. 羊膜移植治疗睑球粘连36例临床分析. 中华实用诊断与治疗杂志, 2009, 23(10): 1020-1021.
17. 冯勇刚, 俞海安, 朱鹃芬. 人工生物羊膜贴敷治疗鼻腔粘连的疗效观察. 临床耳鼻咽喉头颈外科杂志, 2010, 24(2): 77-78.
18. 范伟杰, 杨志明, 邓力, 等. 羊膜的基础和临床应用研究进展. 中国修复重建外科杂志, 2006, 20(1): 65-68.
19. Solomon A, Wajngarten M, Alviano F, et al. Suppression of inflammatory and fibrotic responses in allergic inflammation by the amniotic membrane stromal matrix. Clin Exp Allergy, 2005, 35(7) : 941-948.
20. 罗静聪, 李秀群, 杨志明, 等. 脱细胞羊膜的制备及其生物相容性研究. 中国修复重建外科杂志, 2004, 18(2): 108-111.

Chinese Journal of Reparative and Reconstructive Surgery

EXPERIMENTAL STUDY ON HUMAN AMNIOTIC MEMBRANE FOR REPAIRING TENDON SHEATH DEFECT

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