Calder J S, Green C J
Blond-McIndoe Medical Research Centre, Queen Victoria Hospital, Sussex, UK.
J Hand Surg Br. 1995 Aug;20(4):423-8. doi: 10.1016/s0266-7681(05)80147-0.
An interposed segment of nerve was used to enhance the distance over which freeze-thawed muscle autografts will support effective peripheral nerve regeneration. Gaps were created in the sciatic nerves of adult Lewis rats. Regeneration through 1 and 1.5 cm freeze-thawed muscle grafts was compared to regeneration through nerve-muscle sandwich grafts in which muscle grafts of equivalent length were divided and a 2 mm segment of the distal nerve sutured between the two halves of the muscle, providing an intermediate depot of Schwann cells. Electrophysiological and morphological evaluation was carried out 40 weeks after operation. Despite lengthening the graft, and having four anastomoses instead of two, this manoeuvre enhanced nerve regeneration over each gap studied and for the 1.5 cm gaps compared favourably with perfect match nerve autografts. In addition, a number of grafts were examined at 7 and 14 days by S100 immunohistochemistry. Schwann cell migration was seen to proceed both proximally and distally from the intermediate segment at a rate similar to that from the distal stump. It is concluded that sandwich grafts may prove to be effective alternatives to cutaneous nerve grafts for peripheral nerve reconstruction.
采用一段插入神经来增加冻融肌肉自体移植所能支持有效周围神经再生的距离。在成年Lewis大鼠的坐骨神经上制造缺口。将通过1厘米和1.5厘米冻融肌肉移植物的再生情况与通过神经 - 肌肉三明治移植物的再生情况进行比较，在神经 - 肌肉三明治移植物中，将同等长度的肌肉移植物分开，并将2毫米长的远端神经段缝合在两半肌肉之间，提供雪旺细胞的中间储存库。术后40周进行电生理和形态学评估。尽管延长了移植物并增加了四个吻合口而非两个，但这种操作增强了在所研究的每个缺口中的神经再生，并且对于1.5厘米的缺口，与完美匹配的神经自体移植相比效果良好。此外，在第7天和第14天通过S100免疫组织化学检查了一些移植物。可见雪旺细胞从中间段向近端和远端迁移，迁移速率与从远端残端迁移的速率相似。结论是，三明治移植物可能被证明是用于周围神经重建的皮神经移植物的有效替代物。
