Behavior of Cellulose Biosynthetic Membrane as a Peritendinous Implant in Foals
Background: Tendon injuries are common in horses and are commonly associated with lameness and athletic career disruption. Adhesions formed between the tendons and the surrounding tissues compromise the sliding and movement of the structures, compromising their functionality. Therefore, the control of adhesion formation is critical to restore the structural integrity of the tendon, as well as its biomechanical function. The aim of this study was to evaluate the behavior of the biosynthetic cellulose membrane implanted in foals with surgically induced tendinitis of the superficial digital flexor.
Materials, Methods & Results: Six healthy foals were used, which underwent tendinitis induction in the superficial digital flexor of the right and left forelimbs. The lesions was induced by local ischemia by crushing the tendon with hemostatic forceps. The biosynthetic cellulose membranewas implanted only in the right forelimb, involving the superficial digital flexor tendon in the region of the ischemia and the left forelimb was used as control. After surgery, both forelimb were immobilized with synthetic plaster cast for 15 days. Ultrasonography was performed in six foals immediately before (M0), at 15° (M1) at and 30° (M2) day, and three were evaluate at 45° (M3) and 60° (M4) day after surgery. Incisional biopsies were performed in three animals on the 30° day and in three animals on the 60° day after surgery. Histopathological examination involved the analysis of tissue disorganization, presence and type of inflammatory infiltrate and neovascularization, according to the score of 0 to 3. Ultrasonography allowed visualization of the membrane, which was characterized as a continuous hyperechoic line at the edges of the tendon at 15 days (M1). In addition, at 30 and 45 days after surgery, interruption of the hyperechoic line and reduction of echogenicity were observed, and no echogenic lines were observed at 60 days after surgery. During the biopsies, the fragments obtained from the treated limb were presented with easily detachable layers and separate layers of tissue during histological cutting and the slides preparations. There was no significant difference in relation to the histopathological scores between the treated and control member. The inflammatory infiltrate was predominantly of mononuclear cells and fibroblasts, with identification of giant cell in a foal at 30 days. Neovascularization was observed in all limbs, treated and controls at 30 days and in two treated limbs and three control at 60 days. It was possible to identify the synthetic cellulose membrane by histopathology in only two limbs treated at 30 days and in no limb at 60 days.
Discussion: The degree of tendonitis induced in the present study was considered mild according to ultrasonographic analysis at 15 days after surgery. This fact limited the evaluation of the biosynthetic cellulose membrane in the prevention of adhesions, since they were not observed in both groups. However, the ability of the membrane to minimize adhesion formation can be suggest by the macroscopically observed individualization of the tissue layers during histological sections and slides preparation. Ultrasonographic analysis allowed the visualization of the membrane, as well as its positioning and the absorption process. Therefore, ultrasonography can be used in post-implantation monitoring of the membrane. The comparison of the histopathological scores demonstrates the biocompatibility of the biosynthetic cellulose membrane when implanted in foals submitted to surgically induced tendinitis, since there was no difference when compared to treated and control limbs. Therefore, it can be used safely in the treatment of tendon injuries in horses.
Dowling B.A., Dart A.J., Hodgson D.R. &Smith R.K.W.2000. Superficial digital flexor tendonitis in the horse. Equine Veterinary Journal. 32(5): 369-378.
Foland J.W., Trotter G.W., Powers B.E., Wrigley R.H. & Smith F.W. 1992. Effect of sodium hyaluronate in collagenase-induced superficial digital flexor tendinitis in horses. American Journal of Veterinary Research. 53(12): 2371-2376.
Helenius G., Bäckdahl H., Bodin A., Nannmark U., Gatenholm P. &Risberg B. 2005.In vivo biocompatibility of bacterial cellulose. Journal of Biomedical Materials Research. 76(2): 431-439.
Herculano M.A., Tella Júnior O.I., Prandini M.N. & Alves M.T.S. 2006. Estudo de membrana biológica em ratos na prevenção de fibrose pós laminectomia. Arquivos de Neuro-Psiquiatria. 64(2): 259-263.
Iamaguti L.S. & Brandão C.V.S. 2007.Uso de membrana biossintética a base de celulose na regeneração tecidual guiada. Semina: Ciências Agrárias. 28(4): 701-708.
Lobato R. 2002. Efeitos do ultra-som terapêutico na prevenção de aderências tendinosas. 67f. São Carlos, SP. Dissertação (Mestrado em Bioengenharia) - Programa de Pós-graduação Interunidades em Bioengenharia, Universidade de São Paulo.
Manske P. 1988. Flexor Tendon Healing. Journal of Hand Surgery. 13(3): 237-245.
Mello L.R., Feltrin L.T., Fontes Neto P.T. & Abreu A.R. 1996.Duraplastia com celulose biossintética - estudo experimental. Arquivo Brasileiro de Neurocirurgia. 15:14-21.
Mello L.R., Feltrin Y., Selbach R., Macedo Junior G., Spautz C. & Haas L.J. 2001.Uso da celulose liofilizada em lesões de nervos periféricos com perda de substância. Arquivos de Neuro-Psiquiatria. 59(2): 372-379.
Oliveira R.C.S., Valente P.R., Abou-jamra R.C., Araújo A., Saldiva P.H. & Pedreira D.A.L. 2007.Biosynthetic cellulose induces the formation of a neoduramater following pre-natal correction of meningomyelocele in fetal sheep. Acta Cirurgica Brasileira. 22(2): 174-181.
Pihlajamäki H., Tynninen O., Karjalainen P. & Rokkanen P. 2008.Enveloping bioabsorbable polyglycolide membrane and immobilization in Achilles tendon repair: a comparative experimental study on rabbits.Journal of Orthopaedic Research. 26(2): 264-270.
Schoenau L., Pippi N. &Schossier J. 1993.Avaliação clínica preliminar do fechamento comparativo de incisões corneanas com sutura e Biofill (película celulósica). Ciência Rural. 23(2): 173-177.
Temiz A., Ozturk C., Bakunov A., Kara K. & Kaleli T. 2008.A new material for prevention of peritendinous fibrotic adhesions after tendon repair: oxidised regenerated cellulose (interceed), an absorbable adhesion barrier. International Orthopaedics. 32(3): 389-394.
Wouk A.F.P.F., Diniz J., Círio S., Santos H.D., Baltazar E.L. & Acco A. 1998. Membrana biológica (Biofill) - estudo comparativo com outros agentes promotores da cicatrização da pele em suínos: aspectos clínicos, histopatológicos e morfométricos. Archives of Veterinary Science. 3(1): 31-37.
Xu C., Ma X., Chen S., Tao M., Yuan L. & Jing Y. 2014. Bacterial cellulose membranes used as artificial substitutes for dural defection in rabbits.Internal Journal of Molecular Sciences. 15(6): 10855-10867.
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