Young R C, Wiberg M, Terenghi G
Blond McIndoe Centre, Royal Free and University College Medical School, London, UK.
Br J Plast Surg. 2002 Apr;55(3):235-40. doi: 10.1054/bjps.2002.3798.
The repair of peripheral nerve injuries with an autologous nerve graft is still the treatment of choice, although it is widely recognised that the method is associated with donor-site morbidity and a suboptimal functional outcome. An alternative approach is to use a nerve conduit to provide a guidance channel for the regenerating nerve. This study investigates the potential of poly-3-hydroxybutyrate (PHB) nerve conduits to bridge long nerve gaps (up to 4 cm) in a rabbit common-peroneal-nerve injury model. Regeneration was assessed up to 63 days postoperatively, and compared with that achieved using nerve autografts. By 42 days, regenerating axons had bridged nerve gaps of all lengths in groups with nerve autografts and in those with PHB conduits. The regeneration distance increased with time but did not vary with gap length (P </= 0.009, 14 versus 21 days, PHB tube 2 cm, 3 cm and 4 cm, Mann-Whitney U -test). At 42 days, the area of immunostained regenerating fibres in the PHB group was greater than that in the nerve autograft group (P < 0.001, PHB versus autograft, 21 and 42 days, three-way analysis of variance (ANOVA)). These results suggest that PHB conduits support peripheral nerve regeneration up to 63 days, and that they are suitable for long-gap nerve injury repair.
自体神经移植修复周围神经损伤仍是首选治疗方法，尽管人们普遍认识到该方法存在供体部位并发症且功能恢复效果欠佳。另一种方法是使用神经导管为再生神经提供引导通道。本研究在兔腓总神经损伤模型中，探究聚-3-羟基丁酸酯（PHB）神经导管桥接长达4厘米长神经缺损的潜力。术后长达63天评估神经再生情况，并与自体神经移植的结果进行比较。到42天时，在自体神经移植组和使用PHB导管的组中，再生轴突已跨越了所有长度的神经缺损。再生距离随时间增加，但不随缺损长度变化（P≤0.009，14天与21天比较，PHB导管2厘米、3厘米和4厘米组，曼-惠特尼U检验）。在42天时，PHB组免疫染色的再生纤维面积大于自体神经移植组（P<0.001，PHB与自体神经移植比较，21天和42天，三因素方差分析）。这些结果表明，PHB导管在术后63天内支持周围神经再生，且适用于长间隙神经损伤修复。
