Amaç: Bu çal›flman›n amac› havaya maruz kalan tendon d›fl yüzeyinin kurumas›n›n yap›fl›kl›k oluflumu üzerindeki etkilerini de¤erlendirmek idi. Çal›flma plan›: Altm›fl adet beyaz Yeni Zelanda tavflan›n›n Aflil tendonlar› cerrahi uygulanarak ortaya ç›kar›ld› ve de¤erlendirildi. Kontrol grubundakiler (Grup 1) beklenmeden sütüre edilirken, Grup 2’de- ki tendonlar 60 dakika boyunca hava ile temasa maruz b›rak›ld›; Grup 3’teki tendonlar ise 60 dakika- l›k havayla temas› s›ras›nda düzenli olarak serum fizyolojik ile ›slat›ld›. Klinik muayenesi yap›lan tav- flanlar›n yar›s› operasyondan 3 hafta sonra, di¤er yar›s› da operasyondan 6 hafta sonra sakrifiye edildi. Bulgular: Havaya maruz kalan tüm tendonlarda hafif veya orta düzeyde yap›fl›kl›k gözlendi. Havayla temas s›ras›nda ›slat›lan ve ›slat›lmayan gruplar aras›nda yap›fl›kl›k miktar› aç›s›ndan anlaml› bir fark bulunmazken, bu gruplarla kontrol grubu aras›nda yap›fl›kl›k aç›s›ndan anlaml› fark gözlendi. Klinik muayenede hayvanlar›n arka bacaklar›nda herhangi bir k›s›tlama veya kontraktüre rastlanmad›. Ç›kar›mlar: Tendonlar ›slat›lm›fl olsun veya olmas›n, altm›fl dakikay› aflmayan giriflimlerde tendon çevresinde oluflan yap›fl›kl›klarda anlaml› bir farkl›l›k oluflmamaktad›r.
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1. Loren GJ, Lieber RL. Tendon biomechanical properties enhance human wrist muscle specialization. J Biomech 1995;28:791-9.
2. Meyers SA, Seaber AV, Glisson RR, Nunley JA. Effect of hyaluronic acid/chondroitin sulfate on healing of full-thick- ness tendon lacerations in rabbits. J Orthop Res 1989;7:683- 9.
3. Nyska M, Porat S, Nyska A, Rousso M, Shoshan S. Decreased adhesion formation in flexor tendons by topical application of enriched collagen solution – a histological study. Arch Orthop Trauma Surg 1987;106:192-4.
4. Siddiqi NA, Hamada Y, Ide T, Akamatsu N. Effects of hydroxyapatite and alumina sheaths on postoperative peri- tendinous adhesions in chickens. J Appl Biomater 1995;6:43- 53.
5. Güdemez E, Ekflio¤lu F, Korkusuz P, Aflan E, Gürsel I, Hasirci V. Chondroitin sulfate-coated polyhydroxyethyl methacrylate membrane prevents adhesion in full-thickness tendon tears of rabbits. J Hand Surg Am 2002;27:293-306.
6. Mitchell N, Shepard N. The deleterious effects of drying on articular cartilage. J Bone Joint Surg Am 1989;71:89-95.
7. Abrahamsson SO. Exposure to air during surgery inhibits cellular activity in flexor tendons. J Hand Surg Br 1996;21:299-302.
8. Speer KP, Callaghan JJ, Seaber AV, Tucker JA. The effects of exposure of articular cartilage to air. A histochemical and ultrastructural investigation. J Bone Joint Surg Am 1990;72:1442-50.
9. Fu SC, Hung LK, Lee YW, Mok TY, Chan KM. Tendon adhesion measured by a video-assisted gliding test in a chick- en model. J Hand Surg Eur 2011;36:40-7.
10. Zhao C, Amadio PC, Tanaka T, Kutsumi K, Tsubone T, Zobitz ME, et al. Effect of gap size on gliding resistance after flexor tendon repair. J Bone Joint Surg Am 2004;86-A:2482- 8.
11. Gelberman RH, Menon J, Gonsalves M, Akeson WH. The effects of mobilization on the vascularization of healing flex- or tendons in dogs. Clin Orthop Relat Res 1980;(153):283- 9.
12. Palmes D, Spiegel HU, Schneider TO, Langer M, Stratmann U, Budny T, et al. Achilles tendon healing: long- term biomechanical effects of postoperative mobilization and immobilization in a new mouse model. J Orthop Res 2002;20:939-46.