Effects of human amniotic fluid on peritendinous adhesion formation and tendon healing after flexor tendon surgery in rabbits

The effect of the topical application of human amniotic fluid (HAF) on peri tendinous adhesion formation and tendon healing was investigated in 32 New Zealand adult rabbits. The long flexor tendons of the digits of each hind p aw were completely divided and repaired with a modified Kessler technique. The rabbits were randomly divided into 4 experimental groups according to t he type of repair used: sheath excision, sheath excision and local HAF appl ication, sheath repair, and sheath repair and local HAF application. The ex tent of adhesions and the healing status of the tendons were macroscopicall y and histologically evaluated at 12 weeks. Tensile strength of the repaire d tendons was measured biomechanically at 20 weeks. The least adhesion and the best healing were observed in tendons treated with sheath repair and HA F application. Tendons treated with HAF had significantly higher tensile lo ad values. Topical application of HAF immediately after tenorrhaphy is sign ificantly effective in preventing peritendinous adhesion formation without impairment of tendon healing in this rabbit model. (J Hand Surg 2001;26A:33 2-339. Copyright (C) 2001 by the American Society for Surgery of the Hand.) .