Electrospun Water-Borne Polyurethane Nanofibrous Membrane as a Barrier for Preventing Postoperative Peritendinous Adhesion.

Pang-Yun Chou,Feng-Huei Lin,Shih-Heng Chen,Zhi-Yu Chen

doi:10.3390/ijms20071625

Abstract

Peritendinous adhesion is a major complication after tendon injury and the subsequent repairs or reconstructions. The degree of adhesion can be reduced by the interposition of a membranous barrier between the traumatized tendon and the surrounding tissue. In the present study, electrospun water-borne polyurethane (WPU) nanofibrous membranes (NFMs) were created for use after the reparation or reconstruction of tendons to reduce adhesion. In the electrospinning process, water was employed as the solvent for WPU, and this solvent was ecofriendly and nontoxic. The nanofibrous architecture and pore size of the WPU NFMs were analyzed. Their microporosity (0.78–1.05 µm) blocked the penetration of fibroblasts, which could result in adhesion and scarring around the tendon during healing. The release of WPU mimicked the lubrication effect of the synovial fluid produced by the synovium around the tendon. In vitro cell studies revealed that the WPU NFMs effectively reduced the number of fibroblasts that became attached and that there was no significant cytotoxicity. In vivo studies with the rabbit flexor tendon repair model revealed that WPU NFMs reduced the degree of peritendinous adhesion, as determined using a gross examination; a histological cross section evaluation; and measurements of the range of motion of interphalangeal joints (97.1 ± 14.7 and 79.0 ± 12.4 degrees in proximal and distal interphalangeal joints respectively), of the length of tendon excursion (11.6 ± 1.9 cm), and of the biomechanical properties.

Highlights

Tendons are formed from collagenous tissue that connects muscles to bones in limbs
The pathophysiology of adhesion formation following tendon injury and its subsequent repair is still not fully understood but is believed to be related to the extrinsic healing process led by local fibroblasts [9]
Our results demonstrated that the W1P1 nanofibrous membranes (NFMs) is a favorable tendon barrier for preventing adhesion after tendon surgery and does not hinder tendon healing

Summary

Introduction

Tendons are formed from collagenous tissue that connects muscles to bones in limbs. Tendons cross the joints in the extremities to facilitate flexion and extension during muscle contraction. Tendon injuries are common in trauma to extremities and require a delicate surgical exploration and the meticulous repair of the ruptured tendons [1,2]. Adhesion and scar formation are commonly related to tissue injury, foreign body reaction, infection, bleeding, and ischemia [5] and are a major component of the normal healing process. During wound and tendon healing, fibrin deposition and scar formation are inevitable and contribute to the subsequent tendon adhesion. Traumas involving the flexor digitorum profundus (FDP) or flexor digitorum superficialis tendons in zone II of the hand are those most frequently complicated by peritendinous adhesion [8]. The pathophysiology of adhesion formation following tendon injury and its subsequent repair is still not fully understood but is believed to be related to the extrinsic healing process led by local fibroblasts [9]

Methods

Results

Discussion

Conclusion