Effect of mitomycin-C on post-operative adhesions in tendon surgery: an experimental study in rats.

We investigated the effect of mitomycin-C on the reduction of the formation of peritendinous fibrous adhesions after tendon repair. In 20 Wistar albino rats the tendo Achillis was cut and repaired using a modified Kessler technique. The rats were divided into two equal groups. In group 1, an injection of mitomycin-C was placed between the tendon and skin of the right leg. In group 2, an identical volume of sterile normal saline was injected on the left side in a similar fashion. All the rats received mitomycin-C or saline for four weeks starting from the day of operation. The animals were killed after 30 days. The formation of peritendinous fibrous tissue, the inflammatory reaction and tendon healing were evaluated. The tensile strength of the repaired tendons was measured biomechanically. Microscopic evidence of the formation of adhesions and inflammation was less in group 1. There was no significant difference in the tensile load required to rupture the repaired tendons in the two groups. Mitomycin-C may therefore provide a simple and inexpensive means of preventing of post-operative adhesions.

[1]  G. Prestwich,et al.  Prevention of peritendinous adhesions using a hyaluronan‐derived hydrogel film following partial‐thickness flexor tendon injury , 2008, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[2]  B. Ata,et al.  Prevention of adhesion formation following ovarian surgery in a standardized animal model: Comparative study of Interceed and double layer Surgicell , 2007, The journal of obstetrics and gynaecology research.

[3]  C. Ozturk,et al.  A new material for prevention of peritendinous fibrotic adhesions after tendon repair: oxidised regenerated cellulose (Interceed), an absorbable adhesion barrier , 2008, International Orthopaedics.

[4]  W. Stenzel,et al.  The role of mitomycin C in reducing recurrence of epidural fibrosis after repeated operation in a laminectomy model in rats. , 2006, Journal of neurosurgery. Spine.

[5]  B. Rinker,et al.  The Use of a Hydrogel Sealant on Flexor Tendon Repairs to Prevent Adhesion Formation , 2006, Annals of plastic surgery.

[6]  S. Uckan,et al.  Mitomycin C Effect on Fibrous Adhesions of Rabbit Temporomandibular Joint , 2005, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[7]  D. Lu,et al.  Evaluation of mitomycin C in reducing postoperative adhesions in strabismus surgery. , 2005, Journal of ocular pharmacology and therapeutics : the official journal of the Association for Ocular Pharmacology and Therapeutics.

[8]  G. Y. Ozgenel.  The effects of a combination of hyaluronic and amniotic membrane on the formation of peritendinous adhesions after flexor tendon surgery in chickens. , 2004, The Journal of bone and joint surgery. British volume.

[9]  Akif Gulec,et al.  Seprafilm® interposition for preventing adhesion formation after tenolysis: An experimental study on the chicken flexor tendons , 2003 .

[10]  K. Takaoka,et al.  Callus Resection for Brachial Plexus Compression Following Stress-Induced First Rib Fracture , 2002, Journal of hand surgery.

[11]  İ. Tuncay,et al.  Effects of hyaluronic acid on postoperative adhesion of tendo calcaneus surgery: an experimental study in rats. , 2002, The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons.

[12]  P. Korkusuz,et al.  Chondroitin sulfate-coated polyhydroxyethyl methacrylate membrane prevents adhesion in full-thickness tendon tears of rabbits. , 2002, The Journal of hand surgery.

[13]  A. Alponat,et al.  Mitomycin-C prevents reformation of intra-abdominal adhesions after adhesiolysis. , 2002, Surgery.

[14]  G. Lundborg,et al.  Brain Plasticity and Hand Surgery: an Overview , 2000, Journal of hand surgery.

[15]  C. Ryan,et al.  Effects of 5-fluorouracil on flexor tendon repair. , 2000, The Journal of hand surgery.

[16]  L. Reinisch,et al.  Preservation of Function and Histologic Appearance in the Injured Glottis With Topical Mitomycin‐C , 1999, The Laryngoscope.

[17]  S. Oztürk,et al.  Prevention of restrictive adhesions in primary tendon repair by HA-membrane: experimental research in chickens. , 1999, British journal of plastic surgery.

[18]  M. Longaker,et al.  Gene Expression of Transforming Growth Factor Beta‐1 in Rabbit Zone II Flexor Tendon Wound Healing: Evidence for Dual Mechanisms of Repair , 1997, Plastic and reconstructive surgery.

[19]  D. Shi,et al.  Biomechanical and histologic evaluation of tendon sheath management. , 1996, The Journal of hand surgery.

[20]  B. Widenfalk,et al.  Fibrin sealant in prevention of flexor tendon adhesions: an experimental study in the rabbit. , 1993, The Journal of hand surgery.

[21]  E. Peacock.  BIOLOGICAL PRINCIPLES IN THE HEALING OF LONG TENDONS. , 1965, The Surgical clinics of North America.