McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15219.
Department of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, 15219.
J Biomed Mater Res B Appl Biomater. 2018 Jul;106(5):1698-1711. doi: 10.1002/jbm.b.33975. Epub 2017 Aug 29.
The outcome of peripheral nerve repair following transection is influenced by a number of factors but almost all approaches require anastomosis of the nerve using technically demanding microsurgical procedures. However, the use of sutures presents a number of unavoidable challenges including additional nerve trauma, stimulation of an inflammatory response, and endoneural fibrosis. The objective of the present study was to determine the efficacy of a sutureless approach to nerve repair. A rat sciatic nerve transection model was used with a laser-activated, chitosan-based adhesive (SurgiLux), combined with different forms of extracellular matrix (ECM), known to promote Schwann cell proliferation and nerve growth both in peripheral nerve applications. Following a 5 mm transection of the sciatic nerve, nerve guide wraps were prepared using: (1) laser-activated adhesive (SurgiLux) alone, (2) SurgiLux incorporating ECM (SurgiLux ECM), (3) ECM secured using SurgiLux, and (4) ECM secured using 8-0 Prolene sutures. A no treatment groups was used as a negative control. Evaluation of tissue remodeling was conducted with histolomorphometric assessment of neuroma, integrity of repair, nerve immunolabeling, ratio of myelinated to non-myelinated fibers, and amount of connective tissue. Quantitative and semi-quantitative analysis of the repaired nerve transections at 6 and 12 weeks showed that that SurgiLux incorporating powdered ECM (SurgiLux ECM), SurgiLux alone and ECM alone all improved the healing response compared to no-treatment controls, with less fibrotic tissue and more nerve staining. Histologic scoring showed that the SurgiLux ECM group showed the greatest increase in histologic score between the two time points tested. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 1698-1711, 2018.
周围神经切断后修复的结果受到许多因素的影响,但几乎所有的方法都需要使用技术要求较高的显微外科手术吻合神经。然而,缝线的使用存在许多不可避免的挑战,包括额外的神经创伤、炎症反应的刺激和神经内膜纤维化。本研究的目的是确定无缝线方法修复神经的效果。使用大鼠坐骨神经横断模型,采用激光激活的壳聚糖基胶粘剂(SurgiLux),结合已知在外周神经应用中促进施万细胞增殖和神经生长的不同形式的细胞外基质(ECM)。坐骨神经横断 5mm 后,使用以下方法制备神经引导套:(1)单独使用激光激活的胶粘剂(SurgiLux),(2)包含 ECM 的 SurgiLux(SurgiLux ECM),(3)使用 SurgiLux 固定的 ECM,和(4)使用 8-0 Prolene 缝线固定的 ECM。未治疗组用作阴性对照。通过对神经瘤、修复完整性、神经免疫标记、有髓纤维与无髓纤维的比例以及结缔组织量的组织重塑进行组织形态计量评估,来评估组织重塑。对 6 周和 12 周修复的神经横断进行定量和半定量分析,结果表明,与未治疗对照组相比,包含粉末状 ECM 的 SurgiLux(SurgiLux ECM)、单独 SurgiLux 和单独 ECM 均改善了愈合反应,纤维化组织较少,神经染色较多。组织学评分显示,在两个测试时间点之间,SurgiLux ECM 组的组织学评分增加最多。© 2017 Wiley Periodicals, Inc. J 生物材料 Res 部分 B:应用生物材料,106B:1698-1711,2018。