Experimental Study On Repair Of Synovialization Of Chicken Tendon Sheath By Small Intestinal Submucosa In Pigs

Objectives:Tendon injuries are usually associated with tendon sheath damage.In the previous point of view,removal of tendon sheaths during repair of tendon injuries helped prevent adhesions.In recent years,it has been gradually recognized that maintaining a complete tendon sheath has a positive effect on preventing tendon adhesion.This topic proposes to use a double sis membrane instead of a sheath.To study its preventive effect on tendon adhesions and analyze the distribution of synovial cells,It provides new options and theoretical basis for preventing tendon adhesion.Methods:Preparation of sis membranes and extracts by physical and chemical methods,Detection of sis membrane repulsion,biological characteristics,etc.Comparison of different methods will be sis implanted in chickens on the local chicken,organ and systemic effects;Seventy-five healthy male Leyhen chickens weighing 2-3 kg were randomly divided into 3 groups of 25 animals each.In group A,the tendon-sheath defect was sutured in situ,group B was the SIS replacement group with tendon sheath defect,and group C was the tendon sheath defect group.A chicken cocoon defect model was constructed and the tendon sheath centered on the A2 pulley was removed by 1 cm in area II and the flexor tendon was not cut.In Group A,the incised sheath was sutured in place with 6/0 sutures.In group B,the tendon sheath defect area was covered with a double-layer SIS to cover the tendon.Sew it to the defect with a 6/0 suture.In group C,the defect after removal of the tendon sheath was not repaired.Postoperative antibiotic prophylaxis and treatment.At 4 weeks after operation,all three groups of ABC were measured for the degree of motion of the joints and the distance of the tendon slip was measured.The histological observation of HE staining was performed to assess the NysKa adhesion score,and the immunohistochemical staining of synovium of the tendon sheath was observed.Analysis of synovial cell counts,distribution,analysis of the extent of sis synovization,The resulting data were analyzed for variance using spss15.0 statistical software.Evaluate the effect of sis on the prevention of adhesions and the extent of sis synovization.Resuijts:The characteristics of the sis membrane showed that the increase in temperature of all chickens after intravenous injection of the extract was within 1.2?.And the body temperature fluctuations before and after the injection were less than 1.6 ?;Subcutaneous injection of leachate after chicken found no white spots,edema or necrosis on the experimental side at 1,6,12,24 hours.White spots were visible 1 hour after injection of 25%alcohol on the control side.The central part of the edema was protuberant.After 12 hours,the color of the white patches gradually became gray.After 24 hours,the central part had necrotic scarring.After the operation,all chickens survived and their activities,diet,and urine were normal.All chicken toe surgical wounds were free of infection,suppuration,and fistulas,all of which healed at one time.SIS specimens were surrounded by surrounding granulation tissue at 1 week after implantation.Lymphocytes and other inflammatory cells were seen around the SIS.At 3 weeks,inflammatory cell infiltration was still seen.There were more macrophages and blood vessels formed in the SIS At 6 weeks,the inflammatory cells almost disappeared.There are many vascular tissues inside.SIS has some tissues that degrade and absorb.Most of the SIS degraded and absorbed at 9 weeks.No degeneration or necrosis of surrounding tissues or SIS rejection was observed..The systemic toxicity test group showed normal diet during the observation period,free movement,no difficulty in breathing,unresponsiveness and other symptoms.After 7 days,the weight of the chicken increased.No ascites was observed by anatomy,and there was no adhesion in the abdominal cavity.There was no abnormality in the heart,liver,spleen,and kidney.With the extension of culture time,the number of cells in each group increased,but there was no significant difference in the number of cells between the groups.In the chicken tendon sheath repair model,compared with the Sis membrane and the control group,the incisions healed well in each group.At 4 weeks after operation,TAM was measured:group A 147.2880±6.9274,group B 140.0400±6.6562,group C 106.1760±12.4643.After statistical analysis,the difference between group A and group B and group C was statistically significant(P<0.05);there was no significant difference between group B and group A(P>0.05).TSD determination:A group 1.2000 ± 0.0764,B group 1.1600 ± 0.0707,C group 0.9080 ± 0.1222.After statistical analysis,the difference between group A and group B and group C was statistically significant(P<0.05).There was no significant difference between group B and group A(P>0.05).HE staining showed that there were obvious gaps between the tendon and the tendon sheath in both groups A and B.In group A,the synovial membranes in the parietal and visceral layers were smooth and continuous;In group B,the visceral synovial membrane of intact tendon sheath was smooth and continuous,and although the formation of parietal synovial membrane was still good but not continuous,in group C,the boundary between tendon and surrounding tissue was unclear and there was obvious fibrous tissue growth.NysKa's method adhesion scores were 0.9600+0.3512 in group A,1.2000+0.4083 in group B,and 2.0800+0.5716 in group C.After statistical analysis,the difference between group A and B and group C was statistically significant(P<0.05);there was no significant difference between group A and group B(P>0.05).Immunohistochemistry:In groups A and B,a large number of synovial cells can be seen,densely arranged and evenly distributed.In group B,the number of synovial cells was slightly smaller than that of group A;in group C,synovial cells were few,sparse,and unevenly distributed.Synovial cell counts:group A 127.5539±29.3512,group B 122.3215±23.3605,group C 60.3522±21.3031.After statistical analysis,the difference between group A and B and group C was statistically significant(P<0.05);there was no significant difference between group A and group B(P>0.05).The trial of double sis membrane replacement of the tendon sheath showed that it can significantly promote the proliferation of synovial cells and relieve tendon adhesions.Conclusions:Sis-membrane implants in chickens proved to be non-toxic,non-immunogenic,and non-rejective.The double sis membrane mimics the tendon sheath structure,which lays a good foundation for the migration and replacement of synovial cells.It not only achieves the isolation but also acts as a lubricant for the synovial membrane.The double-layer sis membrane not only analyzes the mechanism of tendon sheath to prevent adhesion,but also provides a new choice for the treatment of tendon adhesion,a clinical problem,and has good development potential.SIS repair defects in the tendon sheath can effectively prevent tendon adhesions,repair of the defect of the tendon sheath can cause significant tendon adhesions.