REDUCTION OF RESTRICTIVE ADHESIONS BY LOCAL APROTININ APPLICATION ANDPRIMARY SHEATH REPAIR IN SURGICALLY TRAUMATIZED FLEXOR TENDONS OF THERABBIT

The effects of microsurgical and medical treatments on reduction of ad hesions in surgically traumatized flexor tendons of rabbits are quanti fied in this study. The effects of the mentioned techniques were inves tigated for the following 4 groups: (1) neither primary sheath repair nor aprotinin application was done, (2) primary sheath repair was done but no aprotinin was used, (3) primary sheath repair was not done but local aprotinin (15,000 IU/kg) was applied, and (4) primary sheath re pair was done and local aprotinin was applied. At the sixth and twelft h postoperative weeks, the flexor digitorum profundus tendons of the s econd and the third digits were subjected to biomechanical tests. Only the third digit was used in macroscopic and histopathologic evaluatio ns. There were 6 digits included in each subgroup of biomechanical tes ts and 4 digits per subgroup in macroscopic and histopathologic evalua tions. Work of flexion (WOF) values were obtained by calculating the a rea under the load-displacement curve, Percent resistive work of flexi on (PRWOF) was obtained by calculating the difference between the WOF value far the repaired right digit and the WOF value for the contralat eral corresponding nonrepaired digit. Combined primary sheath repair a nd medical treatment yielded the best results in reducing the restrict ive adhesions in injured tendons. The differences between the PRWOF va lues of group 4 were 33.7% +/- 8.2% and 15.8% +/- 7.7% for the sixth a nd twelfth postoperative weeks, respectively. The corresponding values for group 1 were 95.7% +/- 13.8% and 51.75% +/- 10.25%.