Información del artículo
Objetivo
Evaluar la formación de adherencias, labiomecánica y la calidad de la cicatriz tendinosa en un modelo experimental de lesión tendinosa en conejo tras la aplicación de periostio en comparación con ácido hialurónico y politetrafluoroetileno (PTFE).
Material y métodoSección y sutura del tendón de Aquiles del conejo de Nueva Zelanda con interposición de ácido hialurónico, PTFE y periostio. Períodos de sacrificio: 1, 3 y 6 semanas. Intervención de 72 conejos. Se realizó análisis macroscópico de la adherencia, análisis biomecánico (fuerza de ruptura), análisis histológico (colágeno) y análisis digital de imagen (calidad de cicatrización).
ResultadosLos tendones tratados con periostio mostraron menos adherencias que los tratados con ácido hialurónico o PTFE (p < 0,05). En la primera semana aumentó la fuerza de ruptura con respecto al control, excepto en el grupo del PTFE. Los tendones tratados con periostio presentaron una mayor fuerza de ruptura (p < 0,001). También mostraron una mayor superficie de colágeno en la cicatriz (p < 0,05). El perímetro de colágeno en la cicatriz fue menor en los tratados con PTFE. La menor dispersión del colágeno se observó en los tratados con periostio (p < 0,01).
ConclusionesEl periostio disminuyó la formación de adherencias con respecto a los otros grupos de tratamiento. Las sustancias empleadas aumentaron la fuerza de ruptura, y el periostio aún más con respecto a los otros grupos de tratamiento. El análisis digital de imagen puso de manifiesto diferencias en la calidad de la cicatrización de las heridas, de forma que los tendones tratados con periostio mostraron una mayor colagenización que los tratados con ácido hialurónico o PTFE.
Palabras clave:
periostio
cicatrización tendinosa
morfometría
Purpose
To assess the formation of adhesions, the biomechanics and the quality of tendon healing, at the repair site of a tendon lesion, in an experimental rabbit model, comparing the use of periosteum, Hyaluronic Acid (HA) and Polytetrafluoroethylene (PTFE).
Materials and methodsTransection and suture of the Achilles tendon in New Zealand white rabbits through the application of Hyaluronic Acid, Polytetrafluoroethylene and periosteum. The rabbits were put down at: 1, 3 and 6 weeks. We studied the adhesions macroscopically, carried out a biomechanical analysis (rupture strength), studied the histology (collagen), and analysed digital images (quality of healing).
ResultsThe tendons treated with periosteum had fewer adhesions than those treated with HA or PTFE (p < 0.05). During the first week rupture strength increased in all groups when compared to the control group-with the exception of the PTFE group. The tendons treated with periosteum showed a higher rupture strength (p < 0.001), they also had a larger area of collagen at the repair site (p < 0.05). The perimeter of the collagen area at the healing site was smaller in cases treated with PTFE. The smallest dispersion of collagen was seen in cases treated with periosteum (p < 0.01).
ConclusionsThe use of periosteum decreased the formation of adhesions when compared to other treatment groups. All three substances increased rupture strength, but periosteum did so most of all, compared to the other treatment groups. The analysis of digital images clearly showed differences in the quality of wound healing, tendons treated with periosteum showed a greater deposit of collagen than those treated with HA or PTFE.
Key words:
periosteum
tendon healing
morphometrics
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