Bogomolets National Medical University, Kyiv, Ukraine.
Georgian Med News. 2020 Dec(309):124-131.
Mechanical damage to the peripheral nerve is a fairly common type of injury, which is characterized by a complex of long-term neurological disorders and require significant financial costs. The aim of this work is to evaluate the efficiency of sciatic nerve (SN) regeneration after neuroraphy using epineural suture (ES), polyethylene glycol hydrogel (PEG), and fibrin glue (FG). The studies were carried out on 30 white outbred male rats, which were divided into six experimental groups: Group №1: intact rats; Group №2: Sham operated; Group №3: complete transection of the SN; Group №4: nerve repair with ES; Group №5: nerve repair with PEG; Group №6: nerve repair with FG. Functional recovery was assessed at 1, 2, 3, 4 postoperative weeks using a walking-track analysis with subsequent determination of the sciatic nerve functional index (SFI). At 4 weeks, electroneuromyography, histological and morphometric analyzes were performed. The combined analysis indicated that PEG significantly improved functional recovery, both in the SFI index and in the skeletal muscle M-response. Compared to ES and PEG, the use of FG was reflected in a lower significance of the indicators compared to PEG. Statistical analysis indicates a positive effect of PEG and FG on nerve regeneration, although significantly greater remyelination (analysis based on fiber diameter) was confirmed only in the PEG group, which explains the faster functional recovery of the limb. PEG in the form of a hydrogel is a more promising agent in microsurgical restoration of damaged nerves as an adhesive, it promotes rapid nerve regeneration, denervated muscle re-innervation and functional limb recovery.
周围神经的机械损伤是一种相当常见的损伤类型,其特征是一系列长期的神经紊乱,需要大量的财务成本。本工作的目的是评估使用神经外膜缝合(ES)、聚乙二醇水凝胶(PEG)和纤维蛋白胶(FG)进行坐骨神经(SN)修复后的再生效率。研究对象为 30 只白化雄性大鼠,分为 6 个实验组:第 1 组:正常大鼠;第 2 组:假手术;第 3 组:SN 完全横断;第 4 组:ES 修复神经;第 5 组:PEG 修复神经;第 6 组:FG 修复神经。使用行走轨迹分析在术后 1、2、3、4 周评估功能恢复情况,随后测定坐骨神经功能指数(SFI)。在第 4 周进行电肌电图、组织学和形态计量学分析。综合分析表明,PEG 显著改善了功能恢复,无论是 SFI 指数还是骨骼肌 M 反应。与 ES 和 PEG 相比,FG 的使用与 PEG 相比,指标的显著性降低。统计分析表明,PEG 和 FG 对神经再生有积极影响,尽管仅在 PEG 组中证实了更好的髓鞘形成(基于纤维直径的分析),这解释了肢体更快的功能恢复。PEG 作为水凝胶形式是一种更有前途的神经修复剂,作为一种黏合剂,它能促进神经的快速再生、失神经肌肉的再神经支配和肢体功能的恢复。