The Research On Achilles Tendon's Endogenous Healing By Separating Tissues Around Tendon With Kieselgel-tube Then Interruptedly Using VEGF Regionally

Objective:Used kieselgel-tube to separate tissues around achilles tendon,then interruptedly used VEGF at the injuried part to research the function of VEGF on tendon's endogenous healing,and to offer theory of using VEGF to treat damage of tendon in clinic.Methods:24 healthy rabbits with weigth of 2.5kg to 3.0kg were devided into experiment group and controlled group randomly,regardless of female and male,after operation each group was devided into 3 groups of 2-week,4-week,6-week randomly,every group had 4 rabbits.Took the rabbits's right achilles tendons to set up damage model:selected the gastrocnemius branch of achilles tendon to cut,then sheathed the part of sutured tendon with kieselgel-tube,then suture tendon with 5-0 line by improved Kessler's method,the experiment group were added VEGF 100ng at once at the stoma,and at the 7th,14th,21st day after operation added VEGF 100ng at the stoma again,the controlled group were sutured then sheathed the part of sutured tendon with kieselgel-tube without any meteries.Sutured the wounds and fixed the affected limbs with position of knee-straightened and foot-plant flexed after operation.Obtained specimens at the time of 2-week,4-week,6-week after operation, observed the degree of accretion and the specimens after being stained, analysised the pictures,then calculated the area of collagen fibers and the number of fibroblasts at the tendon's injuried part.Result:The tendon's injuried parts of experiment group have no difference in partily accretion by eyes with histological observation compared with controlled group(P＞0.05)at 2,4,6 weeks after operation; at 2 weeks after operation,the numbers of fibroblasts at the tendon's injuried parts of experiment group are larger than controlled group (P＜0.05)and the areas of collagen fibers are larger than controlled group too(P＜0.05);at the 4 weeks after operation,the numbers of fibroblasts at the tendon's injuried parts of experiment group are tess than controlled group(P＜0.05),but the areas of collagen fibers of experiment group are larger than controlled group(P＜0.05);at 6 weeks,the numbers of fibroblasts at the tendon's injuried parts of experiment group are less than controlled group(P＜0.05),but the areas of collagen fibers of experiment group are larger than controlled group(P＜0.05).In each group at 2,4,6 weeks after operation,at experiment group,the numbers of fibroblasts are decreasing progressively from 2 weeks to 6 weeks after operation (P＜0.05),the areas of collagen fibers are increasing progressively (P＜0.05);at controlled group,the areas of collagen fibers are increasing progressively from 2 weeks to 6 weeks(P＜0.05),the numbers of fibroblasts are increasing progressively from 2 weeks to 4 weeks after operation(P＜0.05),while at the 6 week,the numbers are decreasing, compared with the 2,4 weeks'(P＜0.05). Conclusion:Using exogenous VEGF at tendon's injuried part can promote the injuried part to build capillary vessel to improve the nutrition of the injuried part,then to promote and accelerate fibroblasts to multiplicate and maturate,promote collagen fibers to be secreted and maturate,then make tendon's endogenous healing be accelerated.