Swaim S F, Bradley D M, Steiss J E, Powers R D, Buxton D F
Scott-Ritchey Research Center, AL.
Am J Vet Res. 1993 Dec;54(12):2161-70.
After removal of 1 metatarsal pad and formation of a granulation tissue bed, free segmental 6- x 8-mm grafts from digital pads were sutured into recessed same-size recipient sites in the granulation tissue. In 5 dogs, the grafted area had been denervated by excision of a segment of the tibial nerve at the level of the tarsus. The grafted area was not denervated in the remaining 5 dogs. In both groups of dogs, the grafts placed around the periphery of the wound healed, blocked ingrowth of delicate epithelium from the surrounding skin, and provided a tough keratinized epithelium that covered the wound's center. As healing progressed, the grafts coalesced as the wounds contracted. Weight bearing resulted in graft expansion to provide functional weight-bearing tissue. Dogs of the denervated group had clinical and histologic evidence of collateral sensory reinnervation of the denervated area. However, with the exception of 1 dog, results of sensory nerve action potential tests indicated that reinnervation may not have been by way of regeneration across the excisional gap in the nerve. Evaluation of reinnervation of the tibial autonomous zone in 2 additional dogs revealed clinical evidence that collateral reinnervation began between 19 and 28 days after nerve excision and progressed proximad to distad. Results of sensory nerve action potential tests indicated that reinnervation may not have been via regeneration across the excision site. Results of fluorescent tracer studies did not have positive findings regarding the route of collateral reinnervation. Segmental paw pad grafts can be used effectively to provide weight-bearing tissue on a dog's limb. With local nerve damage on the distal portion of the limb, collateral innervation can grow into the area to reinnervate tissues, including pad grafts.
切除一块跖骨垫并形成肉芽组织床后,将取自趾垫的6×8毫米游离节段性移植物缝合到肉芽组织中大小相同的凹陷受区。在5只犬中,通过切除跗关节水平的一段胫神经使移植区域去神经支配。其余5只犬的移植区域未去神经支配。在两组犬中,放置在伤口周边的移植物愈合,阻止了周围皮肤的精细上皮向内生长,并提供了覆盖伤口中心的坚韧角化上皮。随着愈合的进展,移植物随着伤口收缩而融合。负重导致移植物扩张以提供功能性负重组织。去神经支配组的犬有去神经支配区域侧支感觉再支配的临床和组织学证据。然而,除1只犬外,感觉神经动作电位测试结果表明,再支配可能不是通过神经切除间隙的再生实现的。对另外2只犬的胫神经自主区再支配的评估显示,有临床证据表明侧支再支配在神经切除后19至28天开始,并向近端至远端进展。感觉神经动作电位测试结果表明,再支配可能不是通过切除部位的再生实现的。荧光示踪剂研究结果对于侧支再支配的途径没有阳性发现。节段性爪垫移植物可有效用于在犬的肢体上提供负重组织。在肢体远端局部神经损伤的情况下,侧支神经支配可长入该区域以再支配包括垫移植物在内的组织。