Adhesion Prevention with Guardix(R)(Sodium Hyaluronate) After Flexor Tendon Repair in Rabbits

Kim, Hark Young; Chang, Hak; Minn, Kyung Won

Abstract

PURPOSE
Adhesion is the most common and troublesome complication after repair of flexor tendon injury. Recently, the use of sodium hyaluronate derivatives for adhesion prevention is increasing. A commercial product, Guardix(R), sodium hyaluronate(NaHe) combined with carboxymethylcellulose(CMC) has been newly developed as a preventive material for adhesion. We have investigated its effect in rabbits.
METHODS
Twenty seven male New Zealand white rabbits were operated under ketamine anesthesia. After tendon repair in zone II of the hind paw, Guardix(R)(experimental group) or normal saline(control group) was administered. Biomechanical tests were performed to estimate adhesion formation In 2, 4, 8, and 12 weeks after the operation. Maximum tensile load to flex the distal interphalangeal joint 50 degree from its resting state(MTL50) was measured, depicting the amount of adhesion formed. Subsequently, breaking strength was assessed.
RESULTS
There were no postoperative complications such as infection, wound dehiscence, or hematoma. MTL50 was significantly lower in the experimental group than in the control group in 4, 8, 12 weeks(p<0.05). Mean value of MTL50 was 6.64N in the experimental group and 28.53N in the control group in 12 weeks after the surgery. There were no significant differences in breaking strength.
CONCLUSION
Our results indicate that Guardix(R) is helpful in reducing adhesion formation and does not interfere with normal healing processes of the tendon.