Background: Adhesion one of the most complications of tendon repair. Aim and objectives; to evaluate the safety and effectiveness of using a silicon sheet wrapping the tendon after primary repair to prevent adhesion. Patients and methods: This were a prospective case series study that included 20 patients with primary and delayed primary tendon repair. Repaired flexor or extensor tendon was wrapped by silicon sheet. The study was conducted at Al-Azhar University Hospitals (Al-Hussien and Sayed Galal). Results: Post-operative assessment and follow up was done to the studied patients. Our results showed that one patient (5%) had mild soft tissue changes surrounding the tendon. None of patients complicated with adhesions. Mild to moderate edema surrounding the tendon compared with contralateral healthy one was found in 17 patients (85%). Dynamic imaging of the tendon movement (passive) to assess suture site showed vascularization in all patients (100%). Also, echogenicity of stumps was normal in all studied patients (100%). Conclusion: The tendon repair site healed quickly and qualitatively well in the current study with silicon wrapping. The functionally improved range of motion obtained suggests that peritendinous fibrosis has been reduced. During the follow-up, the patient underwent an ultrasound examination. In silicon wrap cases, ultrasound confirmed objectively better tendon healing quality, less oedema, and the absence of other complications