Experimental study and clinical application of effect of chitosan on wound healing of muscle tendons

Objective To investigate the effect of chitosan on wound healing of muscle tendons and clinical application. Methods The flexor tendons of the second and third toes of the hind legs in 24 rabbits were cut off and anastomosed, then chitosan was injected into the tendon sheaths and the broken parts of 12 rabbits as the experimental group. The rest 12 rabbits were injected no chitosan as the control group. The legs of all the rabbits were immobilized with plaster. Six animals in each group were sacrificed and the toes were observed after 3 weeks of immobilization, and the rest 12 were dealt with after 4 weeks of immobilization. All the tendons were observed with naked eyes, under a light microscope and under a transmission electron microscope, respectively. The biomechanics of the tendons were also measured. In clinical application, chitosan was injected into the tendon sheaths and the broken parts of 20 patients with broken flexor tendons, and other 20 patients with broken flexor tendons received no chitosan. Then they were followed up, and their grip strength was measured and the total active movement (TAM) was calculated. Results Gross specimen observation showed tendon's healing in the experimental group was better than that of the control group. Biomechanical tests showed significant difference between the experimental group and the control group ( P 0.05). The observation under light and transmission electron microscopes showed significant difference between the experimental group and the control group. The grip strength and TAM of the hands in clinical practice showed significant difference between the experimental group and the controls ( P 0.01). Conclusions It suggests that chitosan can prevent or reduce the adhesions between tendons and improve the wound healing of tendons.