Altun Idiris, Çıralık Harun
Department of Neurosurgery, Kahramanmaras Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey.
Department of Pathology, Kahramanmaras Sutcu Imam University Medical Faculty, Kahramanmaras, Turkey.
J Korean Neurosurg Soc. 2015 Dec;58(6):504-7. doi: 10.3340/jkns.2015.58.6.504. Epub 2015 Dec 31.
Our aim was to evaluate the histopathological effects of tissue adhesives on peripheral nerve regeneration after experimental sciatic nerve transection in rats and to search whether these tissue adhesives may possess a therapeutic potential in peripheral nerve injuries.
This experimental study was performed using 42 female Wistar-Albino rats distributed in 6 groups subsequent to transection of right sciatic nerves. Group I underwent external circumferential neurolysis; Group II received suture repair; Group III had local polymeric hydrogel based tissue adhesive administration; Group IV received suture repair and polymeric hydrogel based tissue adhesive application together; Group V had gelatin based tissue adhesive application and Group VI had suture repair and gelatin based tissue adhesive together. After a 6-week follow-up period, biopsies were obtained from site of neural injury and groups were compared with respect to histopathological scoring based on inflammatory, degenerative, necrotic and fibrotic changes.
There were remarkable differences between control group and study groups with respect to inflammation (p=0.001), degeneration (p=0.002), necrosis (p=0.007), fibrosis (p<0.001) and vascularity (p=0.001). Histopathological scores were similar between study groups and the only noteworthy difference was that Group V displayed a lower score for necrosis and higher score in terms of vascularization.
Our results imply that tissue adhesives can be useful in repair of peripheral nerve injuries by decreasing the surgical trauma and shortening the duration of intervention. Results with gelatin based tissue adhesive are especially promising since more intense vascularity was observed in tissue after application. However, trials on larger series with longer durations of follow-up are essential for reaching more reliable conclusions.
我们的目的是评估组织粘合剂对大鼠实验性坐骨神经横断后周围神经再生的组织病理学影响，并探究这些组织粘合剂是否可能在周围神经损伤中具有治疗潜力。
本实验研究使用42只雌性Wistar - Albino大鼠，在右侧坐骨神经横断后分为6组。第一组进行外膜周围神经松解术；第二组接受缝合修复；第三组局部应用基于聚合物水凝胶的组织粘合剂；第四组同时接受缝合修复和基于聚合物水凝胶的组织粘合剂应用；第五组应用基于明胶的组织粘合剂；第六组同时进行缝合修复和基于明胶的组织粘合剂应用。经过6周的随访期后，从神经损伤部位获取活检组织，并根据炎症、变性、坏死和纤维化变化对各组进行组织病理学评分比较。
对照组与研究组在炎症（p = 0.001）、变性（p = 0.002）、坏死（p = 0.007）、纤维化（p < 0.001）和血管形成（p = 0.001）方面存在显著差异。研究组之间的组织病理学评分相似，唯一值得注意的差异是第五组在坏死方面得分较低，而在血管化方面得分较高。
我们的结果表明，组织粘合剂可通过减少手术创伤和缩短干预时间，在周围神经损伤修复中发挥作用。基于明胶的组织粘合剂的结果尤其令人鼓舞，因为应用后在组织中观察到更强的血管形成。然而，进行更大样本量、更长随访期的试验对于得出更可靠的结论至关重要。
