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An Experimental Study of Collagenase on Prevention Tendon Adhesion after Operation

Author: SuBo
Tutor: BaiXiZhuang
School: China Medical University
Course: Surgery
Keywords: Collagenase Tendon adhesions Experimental study
CLC: R687.2
Type: Master's thesis
Year: 2002
Downloads: 71
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Abstract

Introduction tendon injury surgery adhesions is one of the common clinical problems, prevention of tendon adhesion is also an important issue of Hand Surgery. In this study, the use of collagenase unique biological role, its application around the tendon injury, observation of the tendon sheath of tendon adhesion formation, to explore new methods of prevention of tendon adhesion. Experimental materials laboratory animals: Lixing chicken 64 weight 1.1-1.9kg (thousands of valley gold feed mill). Randomly divided into 2 groups of 32 control toe and Experimental toe the Ⅲ toe of the left foot. Experimental drugs: 0.5% ketamine, 10% formalin solution, 0.9% sodium chloride injection, collagenase (for the domestic development of powder for injection 1200U / bottle, saline solution). Main experimental apparatus: SWD-10 tensile machine, light microscopy, pathology machines and other equipment. Experimental methods to exercise chicken 64 were randomly divided into experimental and control groups, 32 in each group. Intramuscular injection of anesthetic the animal row ketamine (50mg/kg). Prone position, legs and wings fixed in surgery board iodophor disinfection shop towels. 3 chicken left foot toe metacarpophalangeal joints tourniquet, the 3rd toe near the distal interphalangeal joint to do side Founder incision about 2.5cm incision of the skin and subcutaneous tissue to expose the flexor tendon fiber sheath, side longitudinal incision, sharp knife the Hengduan flexor digitorum profundus tendon from the toe of the superficial flexor tendon at the bifurcation, the formation of the the toe deep flexor tendon rupture model. No damage with 5/0 nylon line, modified Kessler method the suture tendon and suture tendon sheath. Experimental toe by tendon sheath slowly injected the collagenase 100U (0.15ml), control injected with saline 0.15 ml toe. All surgical lower extremity 50% of flexion at the ankle, interphalangeal joint flexion fixed 15% plaster cast, six weeks after the lifting of external fixation. Observation method: 2, 4, 6 and 8 weeks after surgery various animals in each group were sacrificed eight knee amputation above the experimental enough, the following tests. 1. Biomechanical test: after 2 wide a group of animals were sacrificed each week. Experimental foot fixed in the test bench, take Lixing the chicken left foot 3 toe, ankle amputation specimens, the paws Ministry of the incision revealed dish toe flexor deep muscle growth, determination of the flexor digitorum profundus muscle Yiu function. Doors the) muscle imaginary sliding distance measurement: the deep flexor tendon tension shelves with the L94N Rally (tensile speed 20mrn/min) incision from ankle tendon pulled out, measuring the length of the tendon is pulled out. For reflect muscle gall slip power situation and the degree of adhesion. The p) Muscle solutions anastomotic tensile strength determination: remove anastomosis muscle to take adhesions traits observed after the experiment enough bile to retain the length of the upper and lower anastomotic Icm, and carefully drawn consistent muscle source with line proximal flexor waist gradually increase the hanging weight measurement caused by the weight of the anastomotic rupture. 2. The adhesions the traits observed: each group were randomly selected five experimental foot anatomy layer by layer on the the experimental toe and control toe muscle source anastomosis were observed around the anastomotic adhesions, the mobile muscle gall and muscle gall healing. Health and Safety Week adhesions literature L Tang Jinbo Journal of Hand Surgery 1992 8. Flexors Teng healing and adhesion formation in a variety of injuries - a new theory of muscle cross-healing method is divided into five. 3. Histological examination: Each remaining three non-anatomical experiment sufficient interception experiment toe and control toe, and fixed 48 hours after the solution was washed with 10% formalin, decalcified in 5% nitric acid for two weeks. About. 5 cm specimen equalization is divided into three sections, respectively, dehydrated and embedded in paraffin, each section transverse slices two, thickness 5 rm, observed by light microscopy after HE staining observed around the muscle increase collagen content, the number of fibroblasts and adhesions how much. 4. Statistical Methods: The measurement data mean. The standard deviation of k. S) form, the muscle source tension between the two groups than · 2 · compared using t test, P-value <0.05 was considered statistically significant. A result. The biomechanical test: (a) muscle Ya sliding distance measuring: Table 1, the experimental toe control toe tendon sliding distance * m * k. s) after surgery (weeks) control toe Experimental toe 20.6 See the earth 0.1 is 0.997 ± 0 knife 43 \soil 0.052 .110 0.882 8 0.660 t 0.095 0.98 0.030 n = 8: P <0.05: P <0.01 (b) of the muscle solution anastomotic anti- Determination of tensile strength: Table 2 postoperative toe deep flexor Teng anastomotic anti-tension strength * eight k. s) after surgery (weeks) control toe Experimental toe 740 soil 94 750t55 4 1470 ± 741 410 ± 756 * see soil boron IO soil m trillion 30 soil 3O 8 10 * dish O earth ZO n = 5: P <0.05 \experimental group increased significantly, the medium dense adhesions, anastomosis is the most serious. · 3 experimental groups: little granulation tissue and bile sheath-like adhesions. 2 after 4 weeks: control group: dense adhesions, granulation tissue formation, widened, after the sharp separation see anastomotic healing, the sarcolemma mobility. experimental groups: experimental toe gall weeks no obvious granulation tissue and membranous adhesions. anastomotic healing good good muscle gall mobility. 3 after 6 -8 weeks: control group, no significant gap: gall weeks adhesions heavier, more adhesions, the sharp separation see Teng consistent around covered granted scar tissue, the assumptions end has healing muscle gall mobility experimental group : gall week gap surface less Shoots adhesions light, no significant adhesions. proactive scar tissue than the control small group, Teng has healing muscle elegant mobility Table 3 tendon adhesions traits grading surgery after (weeks) control toe the experiment toe ZW

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