Li Yu, Takanari Keisuke, Nakamura Ryota, Kambe Miki, Ebisawa Katsumi, Oishi Mayumi, Kamei Yuzuru
Department of Plastic and Reconstructive Surgery, Aichi Cancer Center, Nagoya, Japan.
Department of Plastic and Reconstructive Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Plast Reconstr Surg Glob Open. 2023 Mar 27;11(3):e4875. doi: 10.1097/GOX.0000000000004875. eCollection 2023 Mar.
The aim of this study was to evaluate whether the Nerbridge, an artificial polyglycolic acid conduit with collagen matrix, is comparable to direct nerve suture in a rat sciatic nerve injury model in a short-gap interposition (SGI) setting.
Sixty-six female Lewis rats were randomly divided into the sham group (n = 13); no reconstruction (no-recon) group (n = 13; rat model with 10 mm sciatic nerve defect); direct group (n = 20; rat sciatic nerve injury directly connected by 10-0 Nylon); and SGI group (n = 20; sciatic nerve injury repaired using 5-mm Nerbridge). Motor function and histological recovery were evaluated. The sciatic nerve and gastrocnemius muscle were harvested for quantification of the degree of nerve regeneration and muscle atrophy.
The SGI and direct groups achieved equal recovery in both functional and histological outcomes. At weeks 3 and 8 postsurgery, there was a significant improvement in the sciatic functional index of the SGI group when compared with that of the no-recon group ( < 0.05). Furthermore, the direct and SGI groups had less muscle atrophy at 4 and 8 weeks postsurgery compared with the no-recon group ( < 0.05). The axon density and diameter at the distal site in the SGI group were significantly higher than that in the no-recon group and comparable to that in the direct and sham groups.
An artificial nerve conduit has equal potential as direct suture in motor nerve reconstruction when used in the SGI setting.
本研究的目的是评估一种带有胶原蛋白基质的人工聚乙醇酸导管Nerbridge在大鼠坐骨神经损伤模型的短间隙植入（SGI）情况下是否与直接神经缝合相当。
66只雌性Lewis大鼠被随机分为假手术组（n = 13）；无重建（无重建）组（n = 13；坐骨神经缺损10毫米的大鼠模型）；直接缝合组（n = 20；大鼠坐骨神经损伤用10-0尼龙线直接连接）；以及SGI组（n = 20；坐骨神经损伤用5毫米的Nerbridge修复）。评估运动功能和组织学恢复情况。采集坐骨神经和腓肠肌以量化神经再生程度和肌肉萎缩情况。
SGI组和直接缝合组在功能和组织学结果上均实现了同等程度的恢复。在术后第3周和第8周，与无重建组相比，SGI组的坐骨神经功能指数有显著改善（<0.05）。此外，与无重建组相比，直接缝合组和SGI组在术后第4周和第8周时肌肉萎缩程度较轻（<0.05）。SGI组远端部位的轴突密度和直径显著高于无重建组，与直接缝合组和假手术组相当。
在SGI情况下使用时，人工神经导管在运动神经重建中与直接缝合具有同等潜力。
