Department of Neurological Surgery, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA.
Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA.
Neurol Res. 2024 Oct;46(10):972-981. doi: 10.1080/01616412.2024.2376307. Epub 2024 Jul 15.
For nerve injuries, not amendable to tensionless epineural coaptation of the nerve, autografts are the preferred treatment. Although absorbable sutures are not recommended for nerve repair, there is no evidence that non-absorbable sutures are superior to absorbable sutures. This study aims to assess the effectiveness of non-absorbable monofilament nylon sutures, absorbable monofilament vicryl sutures, and fibrin glue when used for nerve grafting.
Lewis rats ( = 32) were subjected to a sciatic nerve transection and randomly assigned to a group: graft with Nylon, graft with Vicryl, graft with Fibrin Glue, or no graft. Motor function, sensory function, and thermal pain were assessed during a 12-week recovery period, and immunohistochemistry was used to assess macrophage response.
At 12 weeks, the Vicryl and Nylon groups had significantly larger ankle angles at to lift off, which is a measure of motor function, compared to injured controls ( < 0.05). Grafted rats displayed no difference in thermal response but hypersensitivity to mechanical stimuli compared to the uninjured hindlimb. The Nylon, Vicryl, and Fibrin Glue groups all had significantly less atrophy of the gastrocnemius muscle compared to injured controls ( < 0.0001). In the Fibrin Glue group, 3/9 grafts did not incorporate. The Nylon group had significantly less ( = 0.0004) axon growth surrounding the suture holes compared to the Vicryl group. There were no differences in the axon counts, motor neurons, or sensory neurons between all grafted rats.
These results demonstrate that vicryl sutures work just as well as nylon for nerve recovery after injury and grafting.
对于无法进行无张力神经外膜套接的神经损伤，自体移植物是首选的治疗方法。虽然不建议使用可吸收缝线进行神经修复，但没有证据表明不可吸收缝线优于可吸收缝线。本研究旨在评估不可吸收单丝尼龙缝线、可吸收单丝薇乔缝线和纤维蛋白胶在神经移植中的效果。
将 Lewis 大鼠（n=32）进行坐骨神经切断，并随机分为以下几组：尼龙移植组、薇乔移植组、纤维蛋白胶移植组或无移植组。在 12 周的恢复期间，评估运动功能、感觉功能和热痛，并进行免疫组织化学检查以评估巨噬细胞反应。
在 12 周时，与受伤对照组相比，薇乔和尼龙组的踝关节抬起角度明显更大，这是运动功能的衡量标准（P<0.05）。移植组的热反应没有差异，但对机械刺激的敏感性高于未受伤的后肢。与受伤对照组相比，尼龙、薇乔和纤维蛋白胶组的比目鱼肌萎缩程度明显更小（P<0.0001）。在纤维蛋白胶组中，有 3/9 个移植体未融合。尼龙组缝线孔周围的轴突生长明显少于薇乔组（P=0.0004）。所有移植组的轴突计数、运动神经元和感觉神经元均无差异。
这些结果表明，薇乔缝线在神经损伤和移植后的神经恢复方面与尼龙缝线一样有效。
