Repair of nerve injury by implanting prostheses obtained from isogenic acellular nerve segments

• Published in: Revista española de cirugía ortopédica y traumatología Vol. 61; no. 5; pp. 359 - 366
• Main Authors: García-Medrano, B, Mesuro Domínguez, N, Simón Pérez, Cl, Garrosa García, M, Gayoso Del Villar, S, Mayo Íscar, A, Gayoso Rodríguez, M J, Martín Ferrero, M A
• Format: Journal Article
• Language: English
• Published: Spain 01.09.2017
• Subjects: Animals; Caproates; Female; Guided Tissue Regeneration - instrumentation; Guided Tissue Regeneration - methods; Lactones; Male; Nerve Regeneration; Neurosurgical Procedures - instrumentation; Neurosurgical Procedures - methods; Peripheral Nerve Injuries - physiopathology; Peripheral Nerve Injuries - surgery; Polyesters; Prostheses and Implants; Rats; Rats, Wistar; Sciatic Nerve - injuries; Sciatic Nerve - physiology; Sciatic Nerve - surgery; Sciatic Nerve - transplantation; Suture Techniques; Transplantation, Isogeneic - instrumentation; Transplantation, Isogeneic - methods; Treatment Outcome; Aloinjerto; Isogenic nervous graft; Injerto nervioso isogénico; Chemical acellular method; Prótesis de nervio; Peripheral nerve repair; Regeneración nerviosa; Reparación nervio periférico; Isograft; Isoinjerto; Nerve prosthesis; Descelularización química; Allograft; Nerve regeneration
• ISSN: 1988-8856; 1988-8856
• DOI: 10.1016/j.recote.2017.08.011

When a nerve section with a significant gap occurs, it is necessary to use a prosthesis to suture it. To date an autologous nerve segment graft appears to be the best treatment; but it has several important disadvantages. Our goal is to study the effectiveness of an isogenic acellular nerve prosthesis comparing a simple suture with tubulisation. Four groups of Wistar rats were used. The animals in Group 0 served as donors of nerve segments to graft. Group 1 received the implant with an end-to-end suture. In group 2, the implant was sutured inside an ɛ-caprolactone tube. Group 3 received it in a polylactic-co-glycolic acid tube. We evaluated the motor function (sciatic index and step test in motion), and the regeneration length by histological study of regeneration, after a maximum of 3 weeks. Regeneration was uneven in the three groups. In all groups, there were implants with regenerated nerve fibres at the maximum studied length (15mm) and others where regeneration was scarce. The mean regeneration length was greater in the direct end-to-end suture group (G1), although the regeneration speed was similar in the three groups. Group 1 showed the highest percentage of regeneration, but the variability of results prevents this difference reaching statistical significance. We found no significant differences between the two groups with polymer tubes. For the implantation of isogenic acellular nerve prosthesis, under our experimental conditions, the direct end-to-end suture was more effective than when it isprotected with biopolymer tubes.