The effect of subcutaneously injected nicotine on achilles tendon healing in rabbits

The objective of this study was to evaluate the effect of subcutaneously injected nicotine on transversely transected and sutured achilles tendon healing in an experimental rabbit model. Adult New Zealand rabbits (n=22) weighting 3,000-3,500 g were used in this experimental study. Rabbits were randomly divided into two groups. Achilles tendon was transversely incised and repaired in all animals. In the experiment group subcutaneous injection of Nicotine tartrate 3 mg/kg/day was done. In the control group Serum physiologic injection was done at the same dosage. The injections were made three times a day in equal dosages. Nicotine and SF injections were made until the end of the 8-week, and then all animals were euthanized. Both light microscopic and electron microscopic evaluations were made on 14 animals. In N group light microscopic evaluation showed a visible gap in repair site. The total tendon score represented in N group was less than in SF group. The statistical analysis of the groups was significantly different for total tendon scores (P=0.002). Beside this electron microscopic examination showed inactive and degenerated fibroblasts and irregular collagen fibrils around them as well as collagen synthesis interruption in N group. Biomechanical evaluation was made on eight animals. The average tensile strength values in Group N (139.47±44.55 N) were significantly lower than those in Group SF (265.9±39.01 N) (z=2.309, P=0.029). Nicotine is the major chemical component common to all cigarettes and previously has been shown to affect wound and fracture healing adversely. The results of this study show that nicotine impairs achilles tendon healing after a surgical repair.