A resveratrol-loaded scaffold enhances tendon healing: Histological and biomechanical analysis in a rat Achilles tendon repair model

Abstract

Aim: This study aims to evaluate the effects of Dermalix^® (Dx), a resveratrol-loaded, bioabsorbable scaffold composed of collagen, laminin, and hyaluronic acid, on tendon healing and peritendinous adhesion formation following primary Achilles tendon repair in a rat model.

Materials and Methods: A total of 28 female Wistar Albino rats underwent bilateral Achilles tendon injury and repair using the modified Kessler technique. The right legs were treated with local Dx application over the repair site, while the left legs served as untreated controls. Animals were randomly assigned to one of four groups (n = 7 per group). The groups were defined by the evaluation time point (3 or 6 weeks) and the type of analysis (histological or biomechanical). Assessments included macroscopic adhesion scoring, histological quantification (counts of fibroblasts, fibrocytes, and vessels), and biomechanical testing (maximum load to failure and elongation at rupture). Statistical comparisons were made using t-test, Mann-Whitney U, chi-square , ANOVA, or the Friedman test, as appropriate for the data.

Results: Dx application significantly reduced severity of adhesion at both 3 and 6 weeks (p<0.01). Histological analyses revealed significantly lower fibroblast and fibrocyte counts with more organised collagen alignment in Dx-treated groups (p<0.05). Biomechanically, rupture force was significantly higher in Dx groups at both time points (p<0.01 and p=0.029), while no significant difference was found in elongation distance. The scaffold was resorbed by week 3, without inducing any foreign body reaction or systemic side effects.

Conclusion: The local application of Dx enhanced tendon healing significantly and reduced peritendinous adhesions without compromising biomechanical strength. Its bioabsorbable composition and local antioxidant properties make Dx a promising supportive local treatment option in tendon repair surgery. This is particularly valid in cases with high adhesion risk.