Zhang Meng, An Heng, Gu Zhen, Zhang Yi-Chong, Wan Teng, Jiang Hao-Ran, Zhang Feng-Shi, Jiang Bao-Guo, Han Na, Wen Yong-Qiang, Zhang Pei-Xun
Department of Orthopedics and Trauma, Peking University People's Hospital, Key Laboratory of Trauma and Neural Regeneration, Peking University, National Center for Trauma Medicine, Beijing 100044, China.
Beijing Key Laboratory for Bioengineering and Sensing Technology, Daxing Research Institute, School of Chemistry & Biological Engineering, University of Science & Technology Beijing, Beijing 100083, China.
Int J Biol Macromol. 2023 Dec 31;253(Pt 6):126793. doi: 10.1016/j.ijbiomac.2023.126793. Epub 2023 Sep 13.
The incidence of peripheral nerve injury (PNI) is high worldwide, and a poor prognosis is common. Surgical closure and repair of the affected area are crucial to ensure the effective treatment of peripheral nerve injuries. Despite being the standard treatment approach, reliance on sutures to seal the severed nerve ends introduces several limitations and restrictions. This technique is intricate and time-consuming, and the application of threading and punctate sutures may lead to tissue damage and heightened tension concentrations, thus increasing the risk of fixation failure and local inflammation. This study aimed to develop easily implantable chitosan-based peripheral nerve repair conduits that combine acrylic acid and cleavable N-hydroxysuccinimide to reduce nerve damage during repair. In ex vivo tissue adhesion tests, the conduit achieved maximal interfacial toughness of 705 J m ± 30 J m, allowing continuous bridging of the severed nerve ends. Adhesive repair significantly reduces local inflammation caused by conventional sutures, and the positive charge of chitosan disrupts the bacterial cell wall and reduces implant-related infections. This promises to open new avenues for sutureless nerve repair and reliable medical implants.
全球范围内，周围神经损伤（PNI）的发生率很高，预后不良很常见。对受影响区域进行手术闭合和修复对于确保有效治疗周围神经损伤至关重要。尽管作为标准治疗方法，但依靠缝线来封闭切断的神经末端存在一些局限性和限制。该技术复杂且耗时，穿线和点状缝合的应用可能导致组织损伤和张力集中加剧，从而增加固定失败和局部炎症的风险。本研究旨在开发易于植入的基于壳聚糖的周围神经修复导管，其结合了丙烯酸和可裂解的N-羟基琥珀酰亚胺，以减少修复过程中的神经损伤。在体外组织粘附试验中，该导管实现了705 J m±30 J m的最大界面韧性，能够持续桥接切断的神经末端。粘合修复显著减少了传统缝线引起的局部炎症，壳聚糖的正电荷破坏细菌细胞壁并减少植入相关感染。这有望为无缝合神经修复和可靠的医疗植入物开辟新途径。
