Effects of Hyalobarrier gel and Seprafilm in preventing peritendinous adhesions following crush-type injury in a rat model.

Abstract

In the present study, the aim was to evaluate the effects of Hyalobarrier gel (Anika Therapeutics S.r.l., Abano Terme, Italy) and Seprafilm adhesion barrier (Genzyme Corporation, Cambridge, MA, USA) in the prevention of peritendinous adhesions following a crush-type injury. Twenty five female Wistar Albino rats, weighing 230 to 270 g and 7 to 9 months of age were randomized into 5 groups. Group 1 was the control group, Group 2 comprised the Hyalobarrier gel group, Group 3 was made up of the Seprafilm-treated subjects, Group 4 was the tendon repair and Hyalobarrier gel group, and Group 5 was the tendon repair and Seprafilm group. Two gastrocnemius muscle tendons of each animal, a total of 50 tendons, were used. The animals were sacrificed with the administration of a high dose of anesthetic on postoperative day 40. Macroscopic evaluation of adhesions was classified by 2 blinded researchers according to Tang's adhesion grading system. The number of fibroblasts and the density and formation of collagen fibers were noted for histopathological examination. None of the subjects in Group 2 was determined to have a severe adhesion, and moderate or severe adhesions were detected in Groups 3, 4, and 5. There was no statistically significant difference between Group 2 and the control group (p=0.737). Groups 3, 4, and 5 demonstrated fewer adhesions than Groups 1 and 2 (p<0.05). Groups 4 and 5 had fewer adhesions than Groups 2 and 3 (p<0.05). There was no statistically significant difference between Groups 4 and 3 (p=0.342). The histopathological findings were consistent with the macroscopic findings. Seprafilm was found to be effective in the prevention of peritendinous adhesions following a crush-type injury with or without repair of the tendon fibers. In contrast, Hyalobarrier gel was found to be effective only following repair of the tendon fibers.