Abstract
Anti-adhesion membranes are prospective scaffolds for preventing peritendinous adhesion after injury. However, currently available scaffolds have some limitations, such as low efficacy for anti-adhesion, low quality of tendon healing, and unknown drug interactions. Thus, in this study, we designed an innovative structure involving an integrated dual-layer poly(L-lactic acid) (PLLA) electrospun membrane for preventing peritendonous adhesion by promoting tendon gliding. We investigated the surface morphology and wettability of the fiber scaffold. The adhesion and proliferation of fibroblasts were low on the PLLA fibrous membrane. Compared with single-layer membranes, the dual-layer PLLA fiber scaffold reduced adhesion to the tissues. The gliding space persisted until recovery in chicken extensor flexor tendons in vivo. Thus, this innovative PLLA membrane scaffold could prevent adhesion and promote gliding to facilitate tendon healing.
Highlights
Peritendinous adhesion of tendons after hand surgery (Titan et al, 2019) can cause dysfunction of the extremities and requires complicated re-operative surgery
One key approach to preventing malfunction of the extremities caused by peritendinous adhesion is the promotion of tendon gliding after surgery
These systems are functional in animals, their application has been hindered by the complexity of the production process, low efficacy of anti-adhesive agents, poor quality of tendon healing, and uncertainty regarding the effects of drug delivery
Summary
Peritendinous adhesion of tendons after hand surgery (Titan et al, 2019) can cause dysfunction of the extremities and requires complicated re-operative surgery. Two types of tendon healing, i.e., intrinsic and extrinsic, co-exist after tendon injury. The characteristics of intrinsic healing include tenocyte proliferation and migration into the injury site. One key approach to preventing malfunction of the extremities caused by peritendinous adhesion is the promotion of tendon gliding after surgery. Current innovations cannot completely restrict adhesion during extrinsic healing. Biochemical drugs applied on membranes (such as ibuprofen, microRNAs, basic fibroblast growth factor, and silver nanoparticles) cause side effects or reduce the quality of tendon healing (Shalumon et al, 2018; Zhou et al, 2018; Chen et al, 2019; Zhao et al, 2019)
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