Pentamidine Decreases Adhesion Formation After Flexor Tendon Repair
INTRODUCTION: Adhesion formation is a frequent complication after repair of flexor tendon injuries. Fibrotic tissue scarring occurs as a normal process of healing that results in adhesion formation between tendon and surrounding tissues leading to impaired tendon gliding and adversely impacts digit...
| Format: | Other/Unknown Material |
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| Language: | English |
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Morressier
2017
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| Online Access: | https://doi.org/10.26226/morressier.5c0a5c96f0ad58000b08a24f https://openresearchlibrary.org/ext/api/media/4436ca2e-fab5-4bf6-b3e9-a551096bf61f/assets/external_content.pdf https://openresearchlibrary.org/viewer/4436ca2e-fab5-4bf6-b3e9-a551096bf61f |
| Summary: | INTRODUCTION: Adhesion formation is a frequent complication after repair of flexor tendon injuries. Fibrotic tissue scarring occurs as a normal process of healing that results in adhesion formation between tendon and surrounding tissues leading to impaired tendon gliding and adversely impacts digit functions. A combination of factors is thought to contribute to adhesion formation, including tissue damage, inflammation, suture, and immobilization.1,2 While improvements in repair and care techniques have led to reduced adhesions, many pharmacological agents have also been described. In particular, anti-inflammatory drugs such as indomethacin and ibuprofen have been demonstrated to decrease flexor tendon adhesions.3 Pentamidine is a FDA-approved drug for antimicrobial purposes. It has also been demonstrated to have anti-inflammatory properties and data from our lab has shown that it can inhibit fibrosis in rabbit models of hypertrophic scar. Herein, using a previously described turkey model for flexor tendon repair,4 we investigated the effect of local pentamidine application during surgery in reducing preitendinous adhesion formation.METHODS: The study was approved by the Institutional Animal Care and Use Committee (IACUC). Twelve adult Bourbon Red turkeys were randomly assigned into either control (surgery only) or pentamidine (surgery with drug treatment) groups. The other non-operated third digit served as baseline. The third (middle) digit on either the right or left foot of each turkey was randomly chosen to be surgically repaired. A Z-shaped incision was made at the level of the proximal interphalangeal (PIP) joint on the volar side of the third digit. The flexor digitorum profundus tendon was exposed and a laceration was made 1cm distal to the proximal vinculum. Tendon was repaired with the modified Pennington technique and a circumferential running suture. Fifty mg of pentamidine was then applied to the repair site and skin was closed. The digits were wrapped in cotton and immobilized in a flexion position ... |
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