Effects of Acellular Dermal Matrix and Epidermal Growth Factor on Tendon Healing and Functional Recovery: An Experimental Rat Model Study

Objective: Although flexor tendon injuries are relatively uncommon, they pose significant challenges due to postoperative complications such as adhesion formation and tendon ruptures, potentially resulting in substantial functional impairment.Contemporary research efforts increasingly focus on optimizing surgical outcomes by targeting the biochemical and cellular mechanisms underlying tendon healing.This study aimed to investigate the effects of acellular dermal matrix (ADM) and epidermal growth factor (EGF) on tendon healing, biomechanical strength, and functional recovery in a rat Achilles tendon repair model. Methods:Thirty-three male Sprague-Dawley rats were randomly allocated into three groups: Group 1 (primary repair only), Group 2 (repair with ADM wrapping), and Group 3 (repair with ADM wrapping combined with local EGF injection).At six weeks postoperatively, functional recovery was assessed using the modified Achilles Functional Index (AFI), while biomechanical testing evaluated tensile strength.Histopathological analysis was performed to assess vascularization, fibroblast proliferation, inflammatory infiltration, and collagen deposition.Results: Group 3 exhibited significantly greater tensile strength compared to Group 1 (p<0.008),alongside markedly increased collagen deposition (p=0.007).Functional assessment revealed that AFI scores in Group 3 approximated those of healthy controls, suggesting superior restoration of tendon function.While no significant differences were observed among groups regarding vascularization, inflammatory infiltration or fibroblast activity, ADM usage was associated with enhanced fibroblast proliferation and improved collagen organization. Conclusion:The combination of ADM and EGF significantly improved tendon biomechanical strength and functional recovery in this experimental model.ADM provided a supportive scaffold for cellular integration, whereas EGF augmented collagen synthesis and promoted tissue regeneration.These findings highlight the potential of combined ADM and EGF therapy as a promising approach for enhancing tendon healing.