Özkan Heval Selman, Karataş Silistreli Özlem, Ergür Bekir, İrkören Saime
Department of Plastic and Reconstructive Surgery, Adnan Menderes University Faculty of Medicine, Aydın, Turkey.
Department of Plastic and Reconstructive Surgery, İzmir Atatürk Training and Research Hospital, İzmir, Turkey.
Ulus Travma Acil Cerrahi Derg. 2016 Jan;22(1):7-11. doi: 10.5505/tjtes.2015.12612.
There are many studies in the literature combining vein grafts with cell cultures, muscle, tendon, and nerve tissues, but none of them could replace isolated nerve grafts for nerve repair in clinical settings. There are studies in the literature indicating that adipose tissue derived stromal vascular fraction (SVF) enhances peripheral nerve healing. Considering these facts, an experimental study was performed in rats based on combining SVF with vein grafts for peripheral nerve defect repairs.
The study included 30 rats which were divided in three groups. In the first stage, an 8 mm nerve defect was created in tibial nerve of each rat. In Group 1, the defect was reconstructed with nerve graft, in Group 2, the defect was reconstructed with vein graft, and in Group 3, the defect was reconstructed with vein graft filled with SVF solution. After 3 months, the second surgical stage was performed and nerve biopsies were taken. Tissue samples were observed histopathologically.
There were no statistically meaningful difference between nerve grafts, vein grafts and adipose tissue derived SVF- vein grafts combination groups considering myelin diameter and axonal diameter. Axon count was statistically superior in the nerve graft and study groups when compared to empty vein groups.
In conclusion, our results support the usage of stromal vascular fraction-vein graft combination for peripheral nerve defect repairs.
文献中有许多关于将静脉移植物与细胞培养物、肌肉、肌腱和神经组织相结合的研究，但在临床环境中，它们都无法替代孤立的神经移植物用于神经修复。文献中的研究表明，脂肪组织来源的基质血管成分（SVF）可促进周围神经愈合。考虑到这些事实，我们在大鼠身上进行了一项基于将SVF与静脉移植物相结合用于周围神经缺损修复的实验研究。
该研究包括30只大鼠，分为三组。在第一阶段，在每只大鼠的胫神经上制造一个8毫米的神经缺损。第1组用神经移植物重建缺损，第2组用静脉移植物重建缺损，第3组用填充有SVF溶液的静脉移植物重建缺损。3个月后，进行第二阶段手术并取神经活检。对组织样本进行组织病理学观察。
在髓鞘直径和轴突直径方面，神经移植物、静脉移植物和脂肪组织来源的SVF-静脉移植物组合组之间没有统计学意义上的差异。与空静脉组相比，神经移植物组和研究组的轴突计数在统计学上更优。
总之，我们的结果支持使用基质血管成分-静脉移植物组合来修复周围神经缺损。
