Abstract
Fibrin adhesives are used in the treatment of lesions of the musculoskeletal system not only because of their fixating or hemostatic effects, but also because of the presumed acceleration of wound healing by demands of connective tissue proliferation and production of matrix components. Manufactured fibrin glue is assumed to have antimicrobial properties and to serve as a provisional fiber network and scaffold for fibroblast invasion and matrix deposition as well as for osteoinduction [13, 14, 16, 17]. In the clinical case of an acute Achilles tendon rupture, initial ultrasonographic criteria allow a recruitment for non-operative therapy and a functional after-treatment as an effective regimen: the length of the gap between the tendon stumps up to 1 cm with the ankle in neutral, and the potential of approximation of the torn ends with the foot in 20° plantar flexion [5, 8, 9]. Ultrasonic reassessment during the healing period reveals typical patterns of echogenity, presumably reflecting tissue alterations in the course of scar maturation, and allows a monitoring of the morphology of healing and decision-making about the increase of load bearing in the human course of treatment. The typical patterns of echogenity are defined empirically and may reflect tissue interfaces like capillary vessels in granulation tissue and tendon fibers or bundles (endotenonium) [8, 9], but the latter hypothesis is lacking in an experimental confirmation [3].
This is a preview of subscription content, log in via an institution to check access.
Preview
Unable to display preview. Download preview PDF.
References
Clark RAF, Nielsen LD, Welch MP, McPherson JM (1995) Collagen matrices attenuate the collagen synthetic response of cultured fibroblasts to TGF(i J Cell Sci 108:1251–1261
Thermann H, Frerichs O, Biewener A, Krettek C, Schandelmeier P (1995) Die funktionelle Behandlung der frischen Achillessehnenruptur: eine experimentelle biomechanische Untersuchung. Unfallchirurg 98:507–513
Holch M, Thermann H, Beck A, Tscherene H (1994) Histologische Stadien der Regen-eratheilung der experimentellen Achillessehnenruptur beim Kaninchen unter drei Therapieregimen. Hefte zu Der Unfallchirurg 241:120–125
Hunt TK (1980) Wound healing and wound infection: theory and surgical practice. Appleton, New York
Holch M, Biewener A, Thermann H, Zwipp H (1994) Non-operative treatment of acute Achilles tendon rupture: a clinical concept and experimental results. Sports Exercise Injury 1:18–22
Holch M, Flugk B, Zwipp H (in press) Bedeutung der Sonographie nach Fingerbeuge-sehnennaht. Hefte zu Der Unfallchirurg
Thermann H, Biewener A, Frerichs O, Krettek C, Schandelmeier P (1994) Functional treatment of acute Achilles tendon rupture: biomechanical analysis of tendon healing in an experimental study in the rabbit. In: Schlag G, Bosch P, Matras H (eds) Fibrin sealing in surgical and nonsurgical fields 4. Springer, Heidelberg, pp 94–111
Thermann H, Zwipp H, Tscherne H (1991) Functional treatment of acute Achilles’ tendon rupture: a prospectively randomized study: orthopedic transactions. J Bone Joint Surg (Am) 15:649
Thermann H, Zwipp H, Milbradt H, Reimer P (1989) Die Ultraschallsonographie in der Diagnostic und Verlaufskontrolle der Achillessehnenruptur. Unfallchirurg 92:266–273
Nyström B, Holmlund D (1983) Separation of tendon ends after suture of Achilles tendon. Acta Orthop Scand 54:620–621
SilfVerskiöld KL, May E, Törnvall A (1992) Gap formation during controlled motion after flexor tendon repair in zone II: a prospective clinical study. J Hand Surg 17A:538–546
Brown TD, Fu FH, Hanley EN (1981) Comparative assessment of the early mechanical integrity of rapid tendo achillis rupture in the rabbit. J Trauma 21:951–957
Hedelin H, Lundholm K, Teger-Nilsson AC, Petterson HJ, Peterson S (1983) Influence of local fibrin deposition on granulation tissue formation. J Surg Res 15:312
Schwarz N (1994) Fibrin sealant in bone regeneration. In: Schlag G, Redl H (eds) Fibrin sealing in surgical and nonsurgical fields. Springer, Heidelberg, pp 99–109
Clark RAF (ed) (1991) The molecular and cellular biology of wound repair. Plenum, New York, pp 14–17
Redl H, Schlag G (1992) Properties of different tissue sealants with special emphasis on fibrinogen-based preparations. In: Schlag G, Redl H (eds) Fibrin sealant in operative medicine: vol 7. Traumatology. Springer, New York, pp 27–38
Castor CW (1981) Autacoid regulation of wound healing. In: Tissue repair and regeneration. Elsevier Biomedical Press, New York, pp 177–210
Byers PD, Gray DG, Mostafa A (1981) The healing of bone and articular cartilage. In: Tissue repair and regeneration. Elsevier Biomedical Press, New York, pp 177–210
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1998 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Holch, M., Bienwener, A., Thermann, H., Zwipp, H. (1998). The Role of Fibrin Glue as a Provisional Matrix in Tendon Healing. In: Stark, G.B., Horch, R., TÁczos, E. (eds) Biological Matrices and Tissue Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-60309-9_29
Download citation
DOI: https://doi.org/10.1007/978-3-642-60309-9_29
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-64347-7
Online ISBN: 978-3-642-60309-9
eBook Packages: Springer Book Archive