Journal of the Korean Orthopaedic Association (대한정형외과학회지)

Korean Orthopaedic Association (대한정형외과학회)
권호 표지

The Effectiveness of Polylactic Acid Bioresorbable Film in the Prevention of Adhesion Formation in Tendons

건 유착 형성에 미치는 Polylactic Acid 흡수성 Film의 효용성

Park, Sang-Won;Baek, Jong-Ryoon;Lee, Soon-Hyuck;Chung, Jong-Won;Cho, Hyung-Joon
박상원;백종륜;이순혁;정종원;조형준

  • Published : 20060000
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Abstract

Purpose : To evaluate the effectiveness of a polylactic acid bioresorbable film in the prevention of tendon adhesion after tendon repair. Materials and Methods : Twenty-four adult rabbits (48 cases) were used in this study. In the first (control) group, the flexor tendons of the third toe were cut and a tenorrhaphy was performed. The 2nd group was injected with hyaluronic acid between the tendon and tendon sheath after suturing. The 3rd group underwent an enveloping of the tendon with polylactic acid film, followed by tenorrhaphy. The test animals were euthanized at 1, 2, 3, and 6 weeks after surgery, and the histology and biomechanics were evaluated. Results : Microscopic evaluations revealed fibrosis to be most apparent in group 1, while groups 2 and 3 showed no significant differences. The biomechanical tests, which were carried out using a Universal Testing Machine, revealed that an increase in adhesion strength with time. At 6 weeks after surgery, group 1 exhibited an adhesion strength that was 2.5-3 times greater than that exhibited by groups 2 and 3. Group 2 had a higher adhesion strength than group 3, but this difference was not statistically significant. Conclusion : Increases in granulation tissue and fibrosis during the healing of sutured tendons were observed, and the tested polylactide resorbable film was found to be effective in reducing the level of adhesion formation after tendon repair.

목적: 건 봉합술 후 생기는 건의 유착 방지에 polylactic acid 성분의 bioresorbable film이 유용한지 알아보고자 하였다. 대상 및 방법: 가토 24마리(48예)의 제3족지에서 심 족지 굴근을 절단하고 건을 봉합한 후 조작없이 건막을 봉합한 군을 제1군, 건과 건막 봉합 후에 건과 건막 사이에 hyaluronic acid를 주입한 군을 제2군, 건 봉합 후 film을 봉합 건 주위에 피복 시킨 후 건막 봉합 술을 시행한 군을 제3군으로 나누어 수술 후 1주, 2주, 3주 및 6주에 조직학적 소견 및 생역학적 평가를 하였다. 결 과: 광학 현미경 소견에서 섬유화의 정도는 제1군에서 가장 뚜렷하였고 제2군과 제3군에서는 큰 차이를 보이지 않았다. 만능 시험기를 통한 생역학적 검사상 모든 군에서 시간이 경과할수록 유착력(adhesion strength)은 증가하였다. 술 후 6주에는 제1군이 2군 및 3군에 비해 약 2.5-3배의 유착력을 나타냈고 통계적으로 유의성이 있었으며 제2군이 제3군에 비해 다소 높은 유착력을 나타냈으나 통계적으로 의미있는 차이는 보이지 않았다. 결론: 건 봉합 후 건이 치유됨에 따라 육아조직의 증식과 섬유화가 일어남을 확인하였고 polylactide resorbable film이 건 봉합 후 건 유착 방지에 효과가 있었다.

Keywords

References

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