A novel biodegradable PCL film for tendon reconstruction: Achilles tendon defect model in rats.

This study aims to investigate applicability of poly(epsilon-caprolactone) (PCL) biodegradable films for repair of gaps in Achilles tendons in a rat model, also comparing surgical repair versus no repair approaches. PCL was synthesized with tailor-made properties, then, PCL films were prepared by solvent casting. Seventy-five outbred Sprague-Dawley rats were randomly allocated into five groups: (i) sham operated (skin incision only); (ii) no repair (complete division of the Achilles tendon and plantaris tendon without repair); (iii) Achilles repair (with a modified Kessler type suture); and (iv) plasty of Achilles tendon defects with the biodegradable PCL films, and (v) animals subjected to 1 cm mid-substance defect with no repair. Functional performance was determined from the measurements of hindpaw prints utilizing the Achilles functional index. The animals were killed 8 weeks after surgery and histological and biomechanical evaluations were made. All groups subjected to Achilles tendon division had a significant functional impairment that gradually improved so that by day 28 there were no functional impairments in any group whereas animals with a defect remained impaired. The magnitude of the biomechanical and morphological changes at postoperative 8 weeks were similar for no repair group (conservative), Achilles repair group and tendonplasty group (biodegradable PCL film group). The initial rate of functional recovery was significantly different for primary suture, Achilles repair group and PCL film group (p>0.01). But, at the 28th day, functional recovery was quite similar to the other groups. In summary, our results suggest that the PCL film can be an alternative biomaterial for tendon replacement.

Relevance of mangled extremity severity score to compartment syndromes.

This study investigated the relevance of a mangled extremity severity score (MESS) to the evaluation of intracompartmental pressure in injured patients. We measured intracompartmental pressures with a modification of the Whitesides method and compared these values with MESS in 27 patients after trauma. For 5 of them fasciotomy was necessary to relieve high intracompartmental pressures. In our series MESS seemed to correlate with intracompartmental pressure values (r = 0.733, P < 0.05). We conclude that the MESS system provides objective criteria in determining the risk of a compartment syndrome.