Functional Recovery and Safety of a Novel Hyaluronic Gel/Alginate Sheet for Complex Hand Injuries.

INTRODUCTION

Adhesion formation following hand and microsurgical procedures is a relatively common but often substantial complication, potentially limiting mobility and impairing recovery. A bioresorbable hyaluronic acid (HA)/alginate hydrogel was developed to reduce this risk. This study aimed to 1) evaluate functional recovery after use of this novel hydrogel with grip strength and range of motion (ROM), 2) determine its effect on patient-reported outcomes and pain, and 3) assess its safety and complication profile.

METHODS

A prospective, single-center cohort study was conducted in 17 patients (mean age: 43.5 years; range: 22-69) undergoing tendon repair, fracture fixation, or tenolysis. Intraoperatively, a novel HA/alginate hydrogel was applied circumferentially around the operative tendon. Patients were evaluated preoperatively and postoperatively (five days, 14 days, one month, three months, and six months). Primary outcomes included grip strength, ROM, Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores, return-to-work status, and complications. Paired comparisons were performed between operative and contralateral extremities, with p < 0.05 considered significant.

RESULTS

At three months, the mean grip strength was 55.5 ± 25.8 lbs in the operative hand compared with 68.9 ± 25.0 lbs in the contralateral hand. By six months, grip strength had improved to 64.0 ± 20.9 lbs, compared to 69.9 ± 20.6 lbs, with no significant difference. ROM deficits were most pronounced at the proximal interphalangeal joint early after surgery but improved steadily, with near-symmetric motion at six months. QuickDASH scores improved from 51.2 ± 24.3 at baseline to 16.1 ± 16.6 at six months (p < 0.01). One patient (5.8%) experienced early material extrusion that resolved without intervention. No infections or reoperations occurred.

CONCLUSION

Implementation of an HA/alginate sheet in complex hand surgery was safe and associated with favorable functional recovery and improved patient-reported outcomes. Larger randomized trials are warranted to confirm these preliminary findings.