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THE EFFECT OF THERMAL PRECONDITIONING OF THE LIMB ON FLEXOR TENDON HEALING

From the Department of Surgery, RCSI Education and Research Centre, Beaumont Hospital, Dublin, Ireland, the Department of Orthopaedic Surgery, Mater Misericordiae and Cappagh Hospitals, Dublin, Ireland, the Department of Engineering, University College Dublin, Dublin 4, Ireland and the Departments of Histopathology, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland

Correspondence: Ms Claragh Healy, Education and Research Centre, Beaumont Hospital, Dublin 9, Ireland. Tel./fax: +353 87 4182538. E-mail:claraghhealy{at}rcsi.ie

Thermal preconditioning reduces inflammation by inducing cytoprotective heat shock proteins. We evaluated the role of limb thermal preconditioning in a rabbit model of flexor tendon repair. The treatment groups underwent limb preconditioning by elevating the limb temperature to 41.5 °C for 20 minutes. The animals were sacrificed three and six weeks after flexor tendon repair. Heat shock protein72 expression of the treated limb was measured at 18 hours. Macroscopic analysis demonstrated a significant decrease in adhesion formation in the three week treatment group. The inflammatory infiltrate was significantly reduced for both treatment groups. The difference in ultimate tensile strength was not significant. We conclude that thermal preconditioning of the limb before flexor tendon repair decreases inflammation and adhesion formation in a rabbit model and has the potential to improve clinical outcome of flexor tendon surgery.

Key Words: limb thermal preconditioning • flexor tendon healing • heat shock proteins

Journal of Hand Surgery (European Volume), Vol. 32, No. 3, 289-295 (2007)
DOI: 10.1016/J.JHSB.2007.01.004


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