Tendon adhesion,a prevalent complication affecting over 30%of patients after a tendon injury or surgery,results in joint stiffness and impaired mobility.Although current treatments facilitate tendon repair,they are of...Tendon adhesion,a prevalent complication affecting over 30%of patients after a tendon injury or surgery,results in joint stiffness and impaired mobility.Although current treatments facilitate tendon repair,they are often insufficient in preventing adhesions and promoting optimal healing outcomes.To address these challenges,we developed an oriented cryostructured silk fibroin bandage(OCSFB)using the directional freeze-casting methodology.In vitro studies demonstrated that OCSFB provided a favorable microenvironment for cell viability,proliferation,and alignment,concurrently upregulating the expression of tendon-specific genes.In a rat Achilles tendon model,OCSFB significantly reduced adhesion formation and improved tendon healing.RNA-seq analysis further revealed modulation of cell adhesion molecules,substantiating its role in tissue regeneration.The integration of silk fibroin biocompatibility with a unique microstructure that facilitates cellular adhesion and proliferation renders OCSFB a promising approach for mitigating tendon adhesions and improving repair outcomes,establishing it as a robust candidate for clinical application.展开更多
Purpose:To study the clinical effectiveness of the topical application of tranexamic acid in hand tendon release.Methods:This was a randomized controlled trial conducted after receiving approval from the local ethics ...Purpose:To study the clinical effectiveness of the topical application of tranexamic acid in hand tendon release.Methods:This was a randomized controlled trial conducted after receiving approval from the local ethics committee according to guidelines from the Helsinki Declaration.Eighty patients who underwent hand tendon release operation in our hospital from January 2021 to December 2022 were included and randomly divided into 2 groups.Patients in the tranexamic acid group(40 cases)received intraoperative topical application of 2 g of tranexamic acid after tendon release,while patients in the conventional group(40 cases)did not receive topical application of tranexamic acid during operation.The operation time,perioperative hemoglobin changes,total blood loss,incidence of early postoperative complications,and total active movement(TAM)before surgery and 6 months after surgery were compared between the 2 groups.The continuous variable which follows normal distribution expressed by mean±SD and used t-test to compare between groups.Meanwhile,categorical variables were used by Chi-square test,and a p<0.05 indicated that the differences were statistically significant.Results:Both groups were followed up for 7-18 months,with a mean of 10.3 months.Postoperative decrease in hemoglobin was significantly less in the tranexamic acid group than in the conventional group(t=7.611,p<0.001).The total blood loss in the tranexamic acid group(74.33±20.50)mL was less than that in the conventional group(83.05±17.73)mL,and the difference was statistically significant(p<0.05).Both groups showed improvement in thumb/finger flexion and extension range of motion after surgery,and the TAM improved compared with those before surgery,and the difference was statistically significant(p<0.001).The TAM improved more significantly in the tranexamic acid group(87.68°±10.44°)than in the conventional group(80.47°±10.93°)at 6 months after surgery,with a statistically significant difference(t=3.013,p<0.001).There was no significant difference in operation time and incidence of early postoperative complications between the 2 groups(p=0.798,0.499,respectively).Conclusion:The topical application of tranexamic acid during hand tendon release can significantly reduce postoperative bleeding and improve surgical efficacy,which is worth promoting.展开更多
基金sponsored by the National Natural Science Foundation of China(Nos.52235007,T2121004,and 52325504)the Key R&D Program of Zhejiang(No.2024SSYS0027)+1 种基金the National Key Research and Development Program of China(Nos.2024YFB4607700 and 2024YFB4607703)the China National Postdoctoral Program for Innovative Talents(No.BX20240312)。
文摘Tendon adhesion,a prevalent complication affecting over 30%of patients after a tendon injury or surgery,results in joint stiffness and impaired mobility.Although current treatments facilitate tendon repair,they are often insufficient in preventing adhesions and promoting optimal healing outcomes.To address these challenges,we developed an oriented cryostructured silk fibroin bandage(OCSFB)using the directional freeze-casting methodology.In vitro studies demonstrated that OCSFB provided a favorable microenvironment for cell viability,proliferation,and alignment,concurrently upregulating the expression of tendon-specific genes.In a rat Achilles tendon model,OCSFB significantly reduced adhesion formation and improved tendon healing.RNA-seq analysis further revealed modulation of cell adhesion molecules,substantiating its role in tissue regeneration.The integration of silk fibroin biocompatibility with a unique microstructure that facilitates cellular adhesion and proliferation renders OCSFB a promising approach for mitigating tendon adhesions and improving repair outcomes,establishing it as a robust candidate for clinical application.
基金supported by Wuxi Top Medical Expert Team of Taihu Talent Program and Science and Technology Development Fundation of Wuxi (K20221064).
文摘Purpose:To study the clinical effectiveness of the topical application of tranexamic acid in hand tendon release.Methods:This was a randomized controlled trial conducted after receiving approval from the local ethics committee according to guidelines from the Helsinki Declaration.Eighty patients who underwent hand tendon release operation in our hospital from January 2021 to December 2022 were included and randomly divided into 2 groups.Patients in the tranexamic acid group(40 cases)received intraoperative topical application of 2 g of tranexamic acid after tendon release,while patients in the conventional group(40 cases)did not receive topical application of tranexamic acid during operation.The operation time,perioperative hemoglobin changes,total blood loss,incidence of early postoperative complications,and total active movement(TAM)before surgery and 6 months after surgery were compared between the 2 groups.The continuous variable which follows normal distribution expressed by mean±SD and used t-test to compare between groups.Meanwhile,categorical variables were used by Chi-square test,and a p<0.05 indicated that the differences were statistically significant.Results:Both groups were followed up for 7-18 months,with a mean of 10.3 months.Postoperative decrease in hemoglobin was significantly less in the tranexamic acid group than in the conventional group(t=7.611,p<0.001).The total blood loss in the tranexamic acid group(74.33±20.50)mL was less than that in the conventional group(83.05±17.73)mL,and the difference was statistically significant(p<0.05).Both groups showed improvement in thumb/finger flexion and extension range of motion after surgery,and the TAM improved compared with those before surgery,and the difference was statistically significant(p<0.001).The TAM improved more significantly in the tranexamic acid group(87.68°±10.44°)than in the conventional group(80.47°±10.93°)at 6 months after surgery,with a statistically significant difference(t=3.013,p<0.001).There was no significant difference in operation time and incidence of early postoperative complications between the 2 groups(p=0.798,0.499,respectively).Conclusion:The topical application of tranexamic acid during hand tendon release can significantly reduce postoperative bleeding and improve surgical efficacy,which is worth promoting.
