Abstract
This study was performed to assess the effects of a single 5-minute exposure of 5-fluorouracil
(5-FU) applied topically at the time of flexor tendon repair in an attempt to reduce
postoperative adhesions. The flexor digitorum profundus tendon to the long and fourth
toe of Leghorn chickens was lacerated and primarily repaired using a 2-strand technique.
The repair site was then exposed to a single 5-minute application of 5-FU in concentrations
of 5, 25, or 50 mg/mL. Legs were casted for 3 weeks. After death the tendon was examined
for the work of flexion using a tensile testing machine and examined with light microscopy,
scanning electron microscopy, and transmission electron microscopy for morphologic
and histologic differences in adhesion formation. Forty-seven chickens were examined.
Average work of flexion values were 0.12 J for normal tendon, 0.31 J for operative
controls, 0.34 J for the 5 mg/mL group, 0.15 J for the 25 mg/mL group, and 0.19 J
for the 50 mg/mL group. The work of flexion was significantly reduced in the 25 and
50 mg/mL groups compared with the operative controls (p = .008 and p = .03, respectively).
Histologic sections as graded by a blinded pathologist revealed decreased adhesion
formation in all the 5-FU-treated animals (p < .008). Histologic examination showed
that the highest concentration of 5-FU was not as effective at reducing adhesions
as the 25 mg/mL dose. This appeared to be due to increasing inflammatory changes seen
around and within the tendons of the 50 mg/mL group. Overall, a single intraoperative
application of 5-FU at concentrations of 25 mg/mL appears to be an effective mechanism
for reducing postoperative flexor tendon adhesions. (J Hand Surg 2000;25A:242–251.
Copyright © 2000 by the American Society for Surgery of the Hand.)
Keywords
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Article info
Publication history
Accepted:
December 2,
1999
Received:
September 2,
1999
Footnotes
*Reprint requests: Steven L. Moran, MD, Department of Plastic Surgery, Box 661, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14642.
**Supported by a grant from the American Society for Surgery of the Hand.
*No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.
**0363-5023/00/25A02-0023$3.00/0.
♢J Hand Surg 2000;25A:242–251.
Identification
Copyright
© 2000 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.
