Vargel Ibrahim
Department of Plastic and Reconstructive Surgery, Kirikkale University, Medical Faculty, Kirikkale University Medical Faculty, Kirikkale, Turkey.
J Reconstr Microsurg. 2009 May;25(4):243-53. doi: 10.1055/s-0028-1104557. Epub 2008 Dec 15.
Experimental and clinical studies have demonstrated that vascularized nerve grafts are superior to nonvascularized nerve grafts with respect to healing. By means of the inherent vascularity in vascularized nerve grafts, Schwann cells remain viable, and endoneurial necrosis and fibrosis are not seen. In this study the effects of three different vascularization patterns on the vascular microstructure of a nerve segment in the rat based on the femoral artery and vein was investigated. Sixty adult male Wistar Albino rats were divided into five groups. In each group, a 1.5-cm segment of femoral nerve was transected at two sides, without disturbing the unity of the contents of the femoral sheath. The experimental design consisted of prefabricated venous nerve segment, venous nerve segment, arterial nerve segment, no blood flow, and controls groups. To assess the microstructure of the nerve segment, myelin and Schwann cell morphology and fibrosis were examined. There were many Schwann cells with near normal morphology in the venous nerve segment and arterial nerve segment groups. In conclusion, the venous nerve segment model in which Schwann cell viability was high due to the presence of sufficient and uninterrupted blood supply to the nerve graft, resulting in successful nerve healing, showed superior results over others.
实验和临床研究表明，带血管神经移植在愈合方面优于不带血管神经移植。借助带血管神经移植中固有的血管，雪旺细胞保持存活，且未观察到神经内膜坏死和纤维化。在本研究中，基于股动脉和静脉，研究了三种不同血管化模式对大鼠神经节段血管微观结构的影响。60只成年雄性Wistar白化大鼠被分为五组。每组双侧切断1.5厘米长的股神经段，不干扰股鞘内容物的完整性。实验设计包括预制静脉神经段、静脉神经段、动脉神经段、无血流组和对照组。为评估神经节段的微观结构，检查了髓鞘、雪旺细胞形态和纤维化情况。静脉神经段组和动脉神经段组中有许多形态接近正常的雪旺细胞。总之，静脉神经段模型因对神经移植有充足且不间断的血液供应，雪旺细胞活力高，导致神经成功愈合，其结果优于其他模型。
