Orthopedics, cilt.31, sa.6, 2008 (SCI-Expanded)
Peritendinous adhesions are the most common complication of flexor tendon injuries. Overproduction of transforming growth factor β has been reported as a major cause of tissue fibrosis. This study investigated the effects of suramin, a known inhibitor of transforming growth factor β, on the formation of flexor tendon adhesions in a chicken model. Forty-two chicken flexor tendons that were divided partially were repaired using a modified Kessler technique. The chickens were divided into 3 groups. In group 1 (control), no suramin was administered to the tendon repair site; in group 2, 1 mg of suramin was injected around the tendon repair site; and in group 3, 2 mg of suramin was injected around the tendon repair site. At 6 weeks postoperatively, the animals were sacrificed, and functional, histologic, and biomechanical examinations were performed. There was no difference between the groups in terms of tendon excursion. Histologic evaluation showed adhesions were decreased in the groups treated with suramin. In the biomechanical evaluation, a statistically significant difference was present only between the group treated with 2 mg of suramin and the control group. Although suramin is effective in preventing peritendinous adhesions, it can reduce tendon strength as dose-dependent. Future studies should be performed with different doses to determine clinical application.