| Objective:Tendon injuries are very common in clinical practice. Preven ting adhesions after tendon repair surgery, particularly adhesion after flexor tendon injury, is a difficult problem for hand surgery, so prevention of tendon adhesion is currently the Hand Surgery an important issue. At present the view that tendon nutrition rely mainly on blood supply, synovial fluid nutrition and the direct involvement of lymph. Tendon healing way is divided into two kinds of exogenous and endogenous healing ways.Namely, tendon and the surround ing tissues were involved in tendon injury and repair process.The main endogenous healing occurs when the tendon and surrounding tissues less adhesion and the exogenous healing process is closely related to the scar adhesion. Minimizing scar adhesion in the process of tendon healing after tendon injury by promoting endogenous tendon healing process and inhibiting excessive exogenous healing process has become new methods to prevent adhesion after tendon injury.Compared with the poly DL-lactic acid absorbable anti-adhesion membrane produced by Chengdu dicon, the effect of prevention of flexor tendon repair in the clinical application of postsurgical adhesion produced by Beijing production of absorbable hemostatic membrane is studied in this paper.Methods: According to principles of randomized controlled, the 12 cases of acute flexor tendon of hand or forearm injuried patients were divided into two groups: the Test Group and the Control Group, 6 patients in each group. In the same operation conditions, the Test Group used the absorbable hemostatic membrane which was produced by Beijing Qing Biotechnology Co., Ltd. to wrap the stump after flexor tendon suture; the Control Group used the poly DL-lactic acid absorbable anti-adhesion membrane which was produced by Chengdu Dicon to wrap the stump. There were 4 cases with neurovascular injury among the 6 cases of 35 tendons in Test Group, and 3 cases among the 6 cases of 33 tendons in Control Group. The injuried tendons were sutured by Johnsons brand 4-0 tendon suture with the improved method of Kessler, postsurgical conventional anti-inflammatory and symptomatic treatment. All patients are plaster fixed limb position on the tendon relaxation, i.e. wrist palmar flexion 30°, the metacarpophalangeal joint flexion 45°, mild finger flexion, fixed for 4 weeks, after 4 weeks to remove the plaster and practice initiative flexion and extension exercises of the fingers.Results:Postoperative wound healed. Only the control group, 1 patient wound redness, swelling, exudate such as inflammatory response phenomena, but did not affect the final result. Postoperative follow-up time: 16 weeks after surgery. 100% of the patients were followed up. The status of the functional recovery of tendon were evaluated by TAM system. The Test Group 6 patients with 35 flexor tendon in an integrated rate of 94.29% fine . The Control Group 6 patients with 33 flexor tendon in an integrated rate of 90.90% fine. By chi-square test,χ2 for the 0.427, P value is greater than 0.05, there is no significant difference.Conclusion:Absorbable hemostatic membrane is mainly composed of sodium hyaluronate, which is the sodium salt form of hyaluronic acid and has all the biological characteristics of hyaluronic acid.Being a composition of connective tissue and synovial fluid ,so Hyaluronic acid has a reliable biocompatible, non-toxic, non-teratogenic & non-carcinogenicity and non-antigenicity, it has been widely in clinical application. Hyaluronic acid gel has polymer fiber network structure and it plays the role of barrier and lubrication on surface of the organization. Hyaluronic acid can inhibit postoperative bleeding and oozing, reduce fibrin calm. Hyaluronic acid can inhibit inflammatory cell migration and phagocytic cells phagocytosis. Exogenous hyaluronic acid can promote fibroblast synthesis of collagen type III, so that smaller and collagen fibers arrange it in order and reduce scar formation. Hyaluronic acid is a temporary protective layer formed on the surface tendon, which played the role of physical barrier to prevent adhesion, so it can regulate angiogenesis, promote tendon blood supply and accelerate endogenous healing. Absorbable hemostatic film is made of biofilms,which has the above-mentioned biological characteristics of sodium hyaluronate. Absorbable hemostatic film has characters of strong adhesion, adhesion of the wound to stop bleeding quickly.It played the role of isolation and is finally broken down into simple sugars in the body which can be absorbed by body. It has no protein component, non-immunogenicity, animal-borne infectious disease risk and local irritation. Absorbable hemostatic film has characteristics of safe, convenient, simple and absorbable in clinical use.It can be effective in preventing the formation of postsurgical adhesion of the flexor tendon repair and has good clinical application prospect.
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