Wlodarczyk Alexie I, Collin Estelle C, Pereira Maria J N, Bindra Randy, Power Dominic M
From TISSIUM, Paris, France.
Griffith University School of Medicine and Dentistry, Gold Coast, Australia.
Plast Reconstr Surg Glob Open. 2024 Sep 12;12(9):e6151. doi: 10.1097/GOX.0000000000006151. eCollection 2024 Sep.
Microsuturing, the gold standard for peripheral nerve repair, can create tension and damage at the repair site, potentially impacting regeneration and causing neuroma formation. A sutureless and atraumatic polymer-assisted system was developed to address this challenge and support peripheral nerve repair. The system is based on a biocompatible and biodegradable biosynthetic polymer and consists of a coaptation chamber and a light-activated polymer for securing to the nerve. In this study, we compare the system's biomechanical performance and mechanism of action to microsutures and fibrin repairs.
The system's fixation force was compared with microsutures and fibrin glue, and evaluated across various nerve diameters through tensile testing. Tension and tissue morphology at the repair site were assessed using finite element modeling and scanning electron microscopy.
The fixation force of the polymer-assisted repair was equivalent to microsutures and superior to fibrin glue. This force increased linearly with nerve diameter, highlighting the correlation between polymer surface contact area and performance. Finite element modeling analysis showed stress concentration at the repair site for microsuture repairs, whereas the polymer-assisted repair dissipated stress along the nerve, away from the repair site. Morphological analysis revealed nerve alignment with no tissue trauma for the polymer-assisted repair, unlike microsutures.
The mechanical performance of the polymer-assisted coaptation system is suitable for peripheral nerve repair. The achieved fixation forces are equivalent to those of microsutures and superior to fibrin glue, minimizing stress concentration at the repair site and avoiding trauma to the severed nerve ends.
显微缝合作为周围神经修复的金标准，可能会在修复部位产生张力和损伤，从而潜在地影响神经再生并导致神经瘤形成。为应对这一挑战并支持周围神经修复，研发了一种无缝合且无创的聚合物辅助系统。该系统基于一种生物相容性和可生物降解的生物合成聚合物，由一个对接腔和一种用于固定神经的光活化聚合物组成。在本研究中，我们将该系统的生物力学性能和作用机制与显微缝合及纤维蛋白修复进行了比较。
将该系统的固定力与显微缝合线和纤维蛋白胶进行比较，并通过拉伸试验在不同神经直径下进行评估。使用有限元建模和扫描电子显微镜评估修复部位的张力和组织形态。
聚合物辅助修复的固定力与显微缝合相当，且优于纤维蛋白胶。该力随神经直径呈线性增加，突出了聚合物表面接触面积与性能之间的相关性。有限元建模分析表明，显微缝合修复在修复部位存在应力集中，而聚合物辅助修复则使应力沿神经消散，远离修复部位。形态学分析显示，与显微缝合不同，聚合物辅助修复时神经排列整齐且无组织损伤。
聚合物辅助对接系统的力学性能适用于周围神经修复。所实现的固定力与显微缝合相当且优于纤维蛋白胶，可将修复部位的应力集中降至最低，并避免对离断神经末端造成损伤。
