Τομέας Χειρουργικής
Library of the School of Health Sciences

2018-07-25

2018

Skouteris Dimitrios

Παναγιώτης Ι. Παπαγγελόπουλος, Καθηγητής, Ιατρική, ΕΚΠΑ
Σωκράτης Βαρυτιμίδης, Καθηγητής, Ιατρική, Πανεπιστήμιο Θεσσαλίας
Πηνελόπη Κορκολοπούλου, Καθηγήτρια, Ιατρική, ΕΚΠΑ
Μιχαήλ Σφακιανάκης, Καθηγητής, Τμήμα Οργάνωσης και Διοίκησης Επιχειρήσεων, Πανεπιστήμιο Πειραιώς
Όλγα Σαββίδου, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Βασίλειος Κοντογεωργάκος, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ
Ανδρέας Μαυρογένης, Επίκουρος Καθηγητής, Ιατρική, ΕΚΠΑ

Η επίδραση των επιλεκτικών και μη επιλεκτικών μη στεροειδών αντιφλεγμονωδών φαρμάκων στη μετατραυματική δημιουργία συμφύσεων των καμπτήρων τενόντων της χειρός. Πειραματική μελέτη σε λευκούς κονίκλους New Zealand

Greek

The effects of COX-2 selective and non selective non steroidal anti-inflammatory drugs on flexor tendon adhesion. An experimental study on New Zealand rabbits

BACKGROUND
Flexor tendon injuries represent a significant burden for both the individual and society because they usually involve young blue and white collar workforce. The proper function of the hand after tendon injury requires on one part the immediate tendon surgical repair and, on the other part, to maintain the ability to slide freely within their sheath.
The inflammatory response and scarring, following injury and suture of the flexor tendons, promote healing, but at the same time prevent them from sliding into their sheath. Therefore, while the formation of scar tissue provides the necessary physical continuity between the sututred ends of the tendon, it restricts, at the same time the range of motion of the fingers. Despite the progress in the surgical techniques and postoperative rehabilitation protocols for preventing adhesions, still several pharmacological agents are being studied in order to inhibit the excessive inflammatory response and scar tissue formation.
The purpose of this study was to investigate the effect of etoricoxib, a highly selective Cycloxygenase 2 (COX-2) inhibitor, in relation to a traditional non selective non steroidal antiflammatory drug (NSAID) in inhibiting adhesion formation following flexor tendon repair in zone II.
METHODS
The experiment included 48 male New Zealand rabbits that underwent surgery of their right forepaws. The deep flexor tendon of the middle finger was transected and repaired and the forepaws were immobilized in a cast for two weeks. All rabbits were assigned in four different groups according to their postoperative medication (placebo, ibuprofen, etoricoxib for 2 weeks and etoricoxib for 4 weeks) and finally were killed after six weeks.
Postoperatively, tendon adhesion formation was assessed biomechamically, measuring the functional stiffness and range of motion of the fingers, and histologically by calculating the total adhesion in serial axial tendon sections. Comparison was performed between the different treatment groups, as well as to the unoperated forepaws.
RESULTS
Based on the histological and biomechanical results we found that all unoperated forepaws had significantly better biomechanical behaviour as expected. Furthermore, both etoricoxib groups presented better results in comparison with the ibuprofen and the placebo groups that were statistically significant. In addition, no significant difference was observed between the two etoricoxib groups or between the ibuprofen and the placebo group.
CONCLUSION
Etoricoxib, as a highly selective COX-2 NSAID, seems to have a more important effect in limiting adhesion formation compared with ibuprofen, a well known non selective NSAID. It is likely that the inhibition of the COX-2 enzyme along with the prolonged elimination half-life presented by etoricoxib offers a greater beneficial effect on tendon repair by reducing the adhesion formation.

Health Sciences

Flexor tendons, Adhesions, Non steroidal antiflammatory drugs

No

0

Yes

486

225

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https://pergamos.lib.uoa.gr/uoa/dl/object/2779238