Improving flexor tendon gliding by using the combination of carboxymethylcellulose-polyethylene oxide on murine model

Andreea Mioara Corduneanu-Luca; Sorin Aurelian Pasca; Camelia Tamas; Dan Cristian Moraru; Bogdan Ciuntu; Cristina Stanescu; Irina Hreniuc-Jemnoschi; Angela Tecuceanu; Teodor Stamate

doi:10.3892/etm.2021.11028

Improving flexor tendon gliding by using the combination of carboxymethylcellulose-polyethylene oxide on murine model

Exp Ther Med. 2022 Jan;23(1):105. doi: 10.3892/etm.2021.11028. Epub 2021 Dec 1.

Authors

Andreea Mioara Corduneanu-Luca¹, Sorin Aurelian Pasca², Camelia Tamas³, Dan Cristian Moraru³, Bogdan Ciuntu⁴, Cristina Stanescu⁵, Irina Hreniuc-Jemnoschi³, Angela Tecuceanu³, Teodor Stamate³

Affiliations

¹ Department of Plastic Surgery, 'Sf Ioan' Children's Hospital, 800487 Galati, Romania.
² Department of Veterinary Pathology, Faculty of Veterinary Medicine, 'Ion Ionescu de la Brad' University of Agricultural Sciences and Veterinary Medicine, 700490 Iasi, Romania.
³ Department of Plastic Surgery, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.
⁴ Department of General Surgery, Faculty of Medicine, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania.
⁵ Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, 'Dunarea de Jos' University, 800216 Galati, Romania.

Abstract

The current approach to flexor tendon injuries is complex and is no longer limited to suturing techniques. Strategies for improving hand function currently include rehabilitation protocols, appropriate suturing materials and techniques, changing the gliding surface by using lubricants and providing growth factors. One product, originally used in spinal surgery, has been shown to be effective in preventing postoperative adhesions. It is a combination of carboxymethylcellulose and polyethylene oxide-Dynavisc^® (FzioMed, Inc.). The aim of the present study was to test the effect of Dynavisc^® on acute injuries of the intrasynovial flexor tendons in the prevention of postoperative adhesions and the improvement of functional results. The study was performed on 20 Wistar rats distributed in two groups. The control group, represented by 10 rats, in which after the reconstruction of the flexor tendon, the peritendinous area was injected with saline solution and the study group, in which the peritendinous area was injected with a single administration of the lubricating gel, Dynavisc^® (carboxymethylcellulose and polyethylene oxide). At 4 and 12 weeks, the rats were sacrificed and tissue biopsy consisted of tendon fragments and adjacent tissue. The evaluation of the results was performed by measuring the adhesion score and observing histological parameters. The presence of important adhesions was found in the control group compared with the group treated with Dynavisc^®, where a supple and smooth tendon, with significantly fewer adhesions were found. The differences between the two groups were significant, thus indicating the efficiency of the lubricant in preventing adhesions. This study supported the important role of Dynavisc^® in the regeneration of the tendon and the peritendinous structures, by limiting aberrant fibrous proliferation in the regeneration process and helping to build a peritendinous space.

Keywords: adhesions; carboxymethylcellulose and polyethylene oxide; flexor tendon; gliding; lubricant.

Grants and funding

Funding: No funding was received.