Endoscopic Surgery for Delayed Wound Healing After Achilles Tendon Suture Repair: A Report of Three Cases

Imaging-Navigated Surgery

It is vitally important to guide or navigate therapeutic proceedings with a direct and visual approach in order to carefully undertake precision medical manipulations and efficiently evaluate the treatments. Imaging-navigated surgery is one of the common and prevailing technologies to realize this target, and more importantly it merges visualized medicine into next-generation theranostic paradigms in modern medicine. Endoscopes, surgical robots, and nanorobots are three major domains in terms of imaging-navigated surgery. The history of endoscopy has seen upgraded developments since the early 1800s. In contrast, surgical robots have been widely used and investigated in recent years, and they came into clinical uses only in the past decades. Nanorobots which closely depend on innovated and multifunctional biomaterials are still in their infancy. All these imaging-navigated technologies show similar and apparent advantages such as minimal invasiveness, minimized pain, positive prognosis, and relatively expected recovery, which have greatly improved surgery efficiency and patients' life quality. Therefore, the imaging-navigated surgery will be discussed in this chapter, and advanced clinical and preclinical medical applications will also be demonstrated for a diverse readers and comprehensive understanding.

Delayed Wound Healing After Achilles Tendon Suture: An Arthroscopic Solution

This technical note describes an arthroscopic technique for treating delayed wound healing after Achilles tendon suture. Ankle arthroscopy is used to clean up the inflammatory tissues and foreign bodies that lead to delayed wound healing, with the advantages of simple postoperative care and low infection risk. This method may provide a less traumatic and low-risk option for the treatment of delayed wound healing after Achilles tendon surgery. The purpose of this technical note is to describe surgical procedures and related recommendations.

Electrospun heparin-loaded nano-fiber sutures for the amelioration of achilles tendon rupture regeneration: in vivo evaluation

Peritendinous blood circulation improvement is a challenge to promote the healing of ruptured tendons in clinical treatment. Although electrospun membranes or scaffolds enable the reduction of complications such as adhesion, however, low efficiency, toxicity issues, the loss of biological activity, and complex electrospinning techniques are all bottlenecks of these systems. Improving the blood supply is crucial for their successful use, which involves promoting the metabolism and nutrient absorption in tendons. Here, a multifunctional, structurally simple strategy involving heparin-loaded sutures (PPH) that are clinically applicable is reported, in the form of electrospun core-shell nanofibers, with the ability to perform sustained release of anticoagulants heparin (verified in our previous publication) for the improvement of the healing of Achilles tendon. The morphology and diameter distribution of the collagen fiber in the PPH group are closely related to the health of the Achilles tendon than those of commercial sutures (CS). The in vivo results of the total collagen content and the expression of collagen type I in the PPH group are more than those of the CS group. After 6 weeks of culture, the tensile strength of the PPH group shows no significant difference compared to the healthy group. The data obtained in this study improves the current understanding on the regeneration of ruptured tendons and presents a promising strategy for clinical treatment.