聚乳酸防粘连膜在肌腱修复中的应用

背景:如何使肌腱修复后少发生或不发生粘连,尽快实现其滑动功能又不影响肌腱本身的愈合?目的:观察聚乳酸防粘连膜在肌腱损伤修复后的防粘连效果。方法:选择解放军南京军区南京总医院骨科收治的手部屈伸肌腱断裂患者60例(共95根肌腱),随机分为2组。生物防粘连膜组采用弘健医用膜包裹吻合口1.5~2.0cm;对照组不使用生物防粘连膜。修复后6个月屈肌腱采用TAM系统评定,伸肌腱采用Miller分级法评定,比较其综合优良率。结果与结论:修复后均随访达半年以上,生物防粘连膜组综合优良率为90%(45/50),高于对照组综合优良率67%(30/45)(P<0.05)。提示聚乳酸防粘连膜临床应用简单便捷,有效降低了肌腱修复后粘连的形成,临床疗效肯定。

Application of poly (D, L-lactic acid) absorbable medical film in tendon repair

BACKGROUND: The present studies are focused on how to reduce or eliminate adhesion after tendon repair to fulfill sliding function soon without affecting the healing of tendon. OBJECTIVE: To observe the anti-adhesion effects of poly (D, L-lactic acid) (PDLLA) absorbable medical film on tendon repair. METHODS: Sixty patients with flexor tendon and stretch tendon rupture (95 tendons) in hand selected from Nanjing General Hospital of Nanjing Military Region were randomly divided into two groups. Anastomosis 1.5-2.0 cm was wrapped by using Hongjian medical membrane in anti-adhesion biomembrance group, while control group did not use biological absorbable medical film. At 6 months after repair, flexor tendon and stretch tendon were detected by using total active movement system and Miller classification respectively for the comparison of comprehensive good rate. RESULTS AND CONCLUSION: The comprehensive good rate in the anti-adhesion biomembrance group (90%, 45/50) was higher than that in the control group (67%, 30/45) during over 6-month follow-up after repair. It is indicated that the clinical application of PDLLA absorbable medical film is easy and convenient to reduce postoperative adhesion effectively after tendon repair, and its clinical effects are confirmed.