gms | German Medical Science

53. Kongress der Deutschen Gesellschaft für Handchirurgie

Deutsche Gesellschaft für Handchirurgie

11.10. - 13.10.2012, Lübeck

Evaluation of a new collagen membrane (Cova ORTHO) in guided tissue regeneration for tenolysis or neurolysis in upper limb surgery. Preliminary results

Meeting Abstract

  • author presenting/speaker Emmanuel Masmejean - Georges-Pompidou European Hospital (HEGP), Hand and peripheral nerves surgery unit, Paris, Frankreich
  • Daniel Tordjman
  • Charles Schlur
  • William Mamane

Deutsche Gesellschaft für Handchirurgie. 53. Kongress der Deutschen Gesellschaft für Handchirurgie. Lübeck, 11.-13.10.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. Doc12dgh18

DOI: 10.3205/12dgh18, URN: urn:nbn:de:0183-12dgh189

Veröffentlicht: 9. Oktober 2012

© 2012 Masmejean et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objective: To prevent frequent complications linked to adherences and fibrosis formed after orthopaedic surgery, medical treatments, cover flaps and more recently, use of biomaterials have been tested to decrease their incidences. Biomaterials, especially membranes can be interposed between the injured and surrounding tissues to avoid contact and formation of the fibrin bridge after surgery on nerves and/or tendons. In this study, we evaluate the efficiency and tolerance of a new membrane designed to guide the healing process and prevent adherences.

Methods: The membrane (Cova ORTHO, Biom’Up, France) is only composed of collagen. Most patients involved required secondary surgery after the initial post trauma surgical procedure for neurolysis or tenolysis. The wet collagen membrane (immersed in physiological serum) was tested by beeing placed around the liberated tissues to ensure protection and avoid adherence formation. 56 patients, mean age 49 y.o., 21 females and 35 males were included for 16 tenolysis and 40 neurolysis. Before surgery, all patients had severe chronic pain with irritative syndrome and/or stiffness of the affected joints. Surgery constantly consisted in the liberation of nerves and/or tendons involved in the adherence and in the protection of the tissue by the collagen membrane.

Results: No allergic or unwanted inflammatory response was observed. After 2 to 11 months, 12 excellent or good results were found after tendon tenolysis. We noted an increase of 38% of active total range of motion (ROM) and of 22% for passive total ROM. After neurolysis, good or excellent results were obtained in 75% of patients. The irritative syndrome was totally resolved in 53% of cases and reduced in 35%. The Quick Dash was improved of 14 points. Paresthesis disappeared in 30% cases and were reduced in 45%.

Conclusion: The preliminary results of a prospective clinical study performed to assess the efficiency and tolerance of a new collagen membrane in the prevention of postsurgical adherence formation and in the guidance of tissue regeneration show a significant reduction of previous irritative syndromes and a recovery of mobility after neurolysis and tenolysis. No adverse event was reported. In some cases, we can also recommend the use of this collagen membrane Cova ORTHO for specific pluritissular lesions in emergency procedures.