Photochemical Sealing Improves Outcome Following Peripheral Neurorrhaphy
Photochemical Sealing Improves Outcome Following Peripheral Neurorrhaphy
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DOI：
10.1016/j.jss.2008.01.025
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发表时间：
2009-01-01
影响因子：
2.2
通讯作者：
Winograd, Jonathan M.
中科院分区：
文献类型：
--
作者：
O'Neill, Anne C.;Randolph, Mark A.;Winograd, Jonathan M.
导论.周围神经横切会引发切断的神经末梢中复杂的分子反应，导致神经营养因子和神经营养因子的释放，这些因子对轴突存活和再生至关重要。在这项研究中，我们测试的假设，密封的神经缝合部位从周围环境中使用光化学结合的神经包裹将优化神经内环境，并增强再生和神经功能恢复。成年大鼠进行单侧坐骨神经切断和标准神经外膜神经修复。用羊膜或自体静脉包裹修复部位，然后使用光化学组织粘合（PTB）密封或用缝线固定。还进行了没有包裹的光化学密封。每隔2周采用步行轨迹分析评估功能恢复情况，并在12周进行神经组织形态计量学评估。与仅用标准神经缝合术治疗的神经相比，用PTB密封的羊膜治疗神经显著改善了功能恢复，并增加了远端轴突和纤维直径以及髓鞘厚度。修复部位的直接PTB密封也改善了功能。与标准神经缝合术相比，缝线固定羊膜和静脉包裹均未表现出功能或组织学恢复的改善。这些结果表明，使用光化学技术用羊膜封闭周围神经修复部位可能导致神经稳态的早期恢复和随后的神经损伤修复的增强。(C)2009爱思唯尔公司All rights reserved.
Introduction. Peripheral nerve transection initiates a complex molecular response in the severed nerve endings, resulting in the release of neurotrophic and neurotropic factors that are central to axonal survival and regeneration. In this study we tested the hypothesis that sealing the neurorrhaphy site from the surrounding environment using a photochemically bonded nerve wrap would optimize the endoneural environment and enhance regeneration and nerve function recovery.Materials and methods. Adult rats underwent unilateral sciatic nerve transection and standard epineural nerve repair. The repair site was wrapped with amniotic membrane or autologous vein and then was either sealed using photochemical tissue bonding (PTB) or secured with sutures. Photochemical sealing without a wrap was also carried out. Functional recovery was assessed at 2-wk intervals using walking track analysis and nerve histomorphometry was assessed at 12 wk.Results. Treating nerves with PTB-sealed amnion significantly improved functional recovery and increased distal axon and fiber diameters and myelin thickness compared to nerves treated with standard neurorrhaphy alone. Direct PTB sealing of the repair site also improved function. Neither amnion secured with sutures nor vein wraps exhibited improved functional or histological recovery compared to standard neurorrhaphy.Conclusions. These results suggest that sealing the peripheral nerve repair site with amnion using a photochemical technique may lead to earlier restoration of neural homeostasis and consequent enhanced repair of nerve injury. (C) 2009 Elsevier Inc. All rights reserved.