Decrease in adhesion formation by a single application of 5-fluorouracil after flexor tendon injury

Using an animal model, the effect of a single intraoperative application of 5-fluorouracil on digital flexor tendon adhesions was assessed. After a st andard partial division of the tendon and immobilization with a stitch, the synoxial sheath in 30 rabbit tendons was treated with 5-fluorouracil solut ion (50 mg/ml)-soaked sponge pledgers for 5 minutes. Buffered saline was su bstituted for 5-fluorouracil in 30 control tendons. The tendons were harves ted 1 week postoperatively, and histologic sections were assessed with a li ght microscope. There was a significant reduction in synovial sheath thicke ning (p < 0.001), cell counts (p < 0.001) and proportional length of adhesi ons (p < 0.001) in the treated tendons. The reduction in synovial reaction and adhesion formation using this "one touch" technique presents a novel st rategy for the management of the clinical problem of postoperative adhesion s complicating tendon injury and repair.