Possible chemical contribution from chromic gut sutures produces disorders of pain sensation like those seen in man.

Recently, it has been reported that loosely constrictive chromic gut ligatures around the sciatic nerve produce behavioral evidence of neuropathic pain in rats. It has been shown that axonal swelling after ligation results in a constriction injury associated with a decrease in the number of both large-diameter myelinated and small-diameter unmyelinated axons, but the mechanism(s) producing spontaneous pain and thermal hyperalgesia remain largely unknown. The present study systematically evaluated potential mechanisms involved in development of the behavioral changes produced by chromic gut ligatures loosely tied around the sciatic nerve. Four ligatures of either silk (4-0), plain gut (4-0), or chromic gut (4-0, 3-0, or 2-0) were placed loosely around the left sciatic nerve of male Sprague-Dawley rats. An additional group of rats had 8 x 0.5 cm sections of 4-0 chromic gut laid adjacent to the left sciatic nerve. The right sciatic nerve was exposed in all rats for sham surgery. The posture and gait of all rats was qualitatively assessed before (day 0) and for 20-30 days after surgery. Rats were tested for evidence of thermal and mechanical hyperalgesia prior to surgery, and on postoperative days 3, 5, 10, 20 and, in some groups, on day 30. Chromic gut, but not plain gut or silk, ligatures placed around or laid next to the sciatic nerve produced an alteration in the posture of rats such that most of the pressure was placed on the heel and medial aspect of the left (ligated) hind paw with the toes held together and plantar-flexed while pressure appeared to be evenly distributed on the right (sham) hind paw. As a result, a pronounced limp was evident, often with the left hind paw held in the air for prolonged periods of time during the first few days after surgery. These postural changes were most pronounced in the 2-0 and 3-0 chromic gut-treated rats. Chromic gut sutures (4-0, 3-0, or 2-0) tied loosely around the left sciatic nerve also produced a 'dose-dependent' decrease in thermal withdrawal latency that was maximal on postoperative day 3 (25%, 39%, and 41%, respectively). The magnitude of the thermal hyperalgesia declined over time such that a return to baseline was observed by postoperative day 20 in 4-0 and 3-0 chromic gut-treated rats.(ABSTRACT TRUNCATED AT 400 WORDS)