A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand

Introduction: Flexor tendon injuries are common and require surgery. Acellular dermal matrix (ADM) is a natural graft used to repair tissues, though infections represent the primary cause of its therapeutic failure. In this study, zinc oxide nanoparticles (ZnO-NPs) were coated on the ADM in order to...

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Main Authors: Seyedeh-Sara Hashemi, Mohsen Pirmoradi, Alireza Rafati, Mehdi Kian, Ali Akbar Mohammadi, Mohamad Ali Hoghoughi
Format: Article
Language:English
Published: Tabriz University of Medical Sciences 2024-09-01
Series:BioImpacts
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Online Access:https://bi.tbzmed.ac.ir/PDF/bi-14-27748.pdf
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author Seyedeh-Sara Hashemi
Mohsen Pirmoradi
Alireza Rafati
Mehdi Kian
Ali Akbar Mohammadi
Mohamad Ali Hoghoughi
author_facet Seyedeh-Sara Hashemi
Mohsen Pirmoradi
Alireza Rafati
Mehdi Kian
Ali Akbar Mohammadi
Mohamad Ali Hoghoughi
author_sort Seyedeh-Sara Hashemi
collection DOAJ
description Introduction: Flexor tendon injuries are common and require surgery. Acellular dermal matrix (ADM) is a natural graft used to repair tissues, though infections represent the primary cause of its therapeutic failure. In this study, zinc oxide nanoparticles (ZnO-NPs) were coated on the ADM in order to add antibacterial potential as well as enhance healing properties. Also, the produced ADM/ZnO-NPs graft was applied to accelerate fifth zone flexor tendon repair following the reconstructive surgery. Methods: Morphological, mechanical, cell viability, and antibacterial tests were performed to evaluate the physical and biological properties of the fabricated ADM/ZnO-NPs graft. For clinical evaluations, 20 patients with a flexor tendon injury in zone 5 were randomly divided into control and treatment with ADM/ZnO-NPs groups (n=10 each). The control group had routine reconstructive surgery, while the other group received the ADM/ZnO- NPs graft during their surgery. Postoperative functional outcomes were evaluated 4, 6, and 8 weeks following the tendon repair surgery according to the Buck-Gramcko II criteria. Results: The ADM/ZnO-NPs had natural derm specifications as well as dense and integrated morphology with intermediate antibacterial properties. According to the Buck- Gramcko II criteria, the postoperative functional outcome scores were significantly higher in the ADM/ZnO-NPs group in comparison with the control group at 4 (P<0.01), 6 (P<0.01), and 8 (P<0.001) weeks after the surgery. Conclusion: The present findings revealed that the ADM/ZnO-NPs graft can accelerate the healing of the damaged tendon without common post-operative functional complications and adhesions following the tendon repair surgery. However, more comprehensive clinical trials are still needed.
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spelling doaj-art-e3387dc4cc6546d7a038ffc9c96a84092025-01-18T10:02:36ZengTabriz University of Medical SciencesBioImpacts2228-56522228-56602024-09-01145277482774810.34172/bi.2024.27748bi-27748A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the handSeyedeh-Sara Hashemi0Mohsen Pirmoradi1Alireza Rafati2Mehdi Kian3Ali Akbar Mohammadi4Mohamad Ali Hoghoughi5Burn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, ‎IranDivision of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of ‎Medical Sciences, Shiraz, IranDivision of Pharmacology and Pharmaceutical Chemistry, Sarvestan Branch, Islamic Azad ‎University, Sarvestan, IranDepartment of Comparative Biomedical Sciences, School of Advanced Medical Sciences and ‎Technologies, Shiraz University of Medical Sciences, Shiraz, Fars, IranBurn and Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, ‎IranDivision of Plastic and Reconstructive Surgery, Department of Surgery, Shiraz University of ‎Medical Sciences, Shiraz, IranIntroduction: Flexor tendon injuries are common and require surgery. Acellular dermal matrix (ADM) is a natural graft used to repair tissues, though infections represent the primary cause of its therapeutic failure. In this study, zinc oxide nanoparticles (ZnO-NPs) were coated on the ADM in order to add antibacterial potential as well as enhance healing properties. Also, the produced ADM/ZnO-NPs graft was applied to accelerate fifth zone flexor tendon repair following the reconstructive surgery. Methods: Morphological, mechanical, cell viability, and antibacterial tests were performed to evaluate the physical and biological properties of the fabricated ADM/ZnO-NPs graft. For clinical evaluations, 20 patients with a flexor tendon injury in zone 5 were randomly divided into control and treatment with ADM/ZnO-NPs groups (n=10 each). The control group had routine reconstructive surgery, while the other group received the ADM/ZnO- NPs graft during their surgery. Postoperative functional outcomes were evaluated 4, 6, and 8 weeks following the tendon repair surgery according to the Buck-Gramcko II criteria. Results: The ADM/ZnO-NPs had natural derm specifications as well as dense and integrated morphology with intermediate antibacterial properties. According to the Buck- Gramcko II criteria, the postoperative functional outcome scores were significantly higher in the ADM/ZnO-NPs group in comparison with the control group at 4 (P<0.01), 6 (P<0.01), and 8 (P<0.001) weeks after the surgery. Conclusion: The present findings revealed that the ADM/ZnO-NPs graft can accelerate the healing of the damaged tendon without common post-operative functional complications and adhesions following the tendon repair surgery. However, more comprehensive clinical trials are still needed.https://bi.tbzmed.ac.ir/PDF/bi-14-27748.pdfacellular dermal matrixzinc oxide nanoparticlesadhesionhealingflexor tendon‎reconstructive surgery
spellingShingle Seyedeh-Sara Hashemi
Mohsen Pirmoradi
Alireza Rafati
Mehdi Kian
Ali Akbar Mohammadi
Mohamad Ali Hoghoughi
A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
BioImpacts
acellular dermal matrix
zinc oxide nanoparticles
adhesion
healing
flexor tendon
‎reconstructive surgery
title A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
title_full A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
title_fullStr A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
title_full_unstemmed A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
title_short A human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
title_sort human acellular dermal matrix coated with zinc oxide nanoparticles accelerates tendon repair in patients with hand flexor tendon injuries in zone 5 of the hand
topic acellular dermal matrix
zinc oxide nanoparticles
adhesion
healing
flexor tendon
‎reconstructive surgery
url https://bi.tbzmed.ac.ir/PDF/bi-14-27748.pdf
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