Reduction of postoperative perineural adhesions by Hyaloglide gel: an experimental study in the rat sciatic nerve.
Reduction of postoperative perineural adhesions by Hyaloglide gel: an experimental study in the rat sciatic nerve.
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DOI：
10.1227/01.neu.0000156845.41626.e9
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发表时间：
2005-04-01
期刊：
影响因子：
4.8
通讯作者：
Tadie, Marc
中科院分区：
文献类型：
--
作者：
Dam-Hieu, Phong;Lacroix, Catherine;Tadie, Marc
目的：评估透明质酸衍生物聚合物 Hyaloglide 凝胶（或自交联多糖 [ACP] 凝胶；Fidia Advanced Biopolymers，阿巴诺泰尔梅，意大利）对周围神经疤痕和神经再生的影响。 方法：我们在成年大鼠中进行了两种外科手术：1）坐骨神经的神经松解及其胫骨和腓骨分支的分离，2）横断并立即缝合坐骨神经。神经操作后，将 ACP 凝胶涂抹于手术部位。我们测试了两种具有不同粘度的 ACP 凝胶溶液。其他动物接受了 Adcon-T/N（Gliatech，Inc.，克利夫兰，俄亥俄州），这是一种目前可用于临床的抗粘连剂。对侧不涂凝胶，作为对照侧。四个星期后，这些动物接受了再次手术。我们评估了伤口愈合的质量、神经周围粘连的存在以及神经与周围组织的可分离性。结果：与对照组相比，使用 ACP 凝胶（高粘度）和 Adcon-T/N 治疗的动物的神经周围粘连明显减少。定量组织学分析显示，经 ACP 凝胶治疗后，神经周围的疤痕组织数量显着减少。没有发现毒性证据，并且该凝胶不会干扰神经再生（再生有髓轴突的计数）。结论：高粘度的 ACP 凝胶对于减少周围神经手术后的神经周围粘连和疤痕形成似乎是安全有效的。
OBJECTIVE: To assess the effects of Hyaloglide gel (or auto-cross-linked polysaccharide [ACP] gel; Fidia Advanced Biopolymers, Abano Terme, Italy), a hyaluronan-derivative polymer, on peripheral nerve scarring and nerve regeneration.METHODS: We performed two surgical procedures in adult rats: 1) neurolysis of the sciatic nerve and separation of its tibial and peroneal branches, and 2) transection and immediate suture of the sciatic nerve. After nerve manipulation, ACP gel was applied onto the site of operation. We tested two solutions of ACP gel having different viscosities. Additional animals received Adcon-T/N (Gliatech, Inc., Cleveland, OH), an antiadhesive agent currently available for clinical use. No gel was applied on the contralateral side, which served as a control side. Four weeks later, the animals underwent reoperation. We assessed the quality of wound healing, the presence of perineural adherences, and the separability of nerves from surrounding tissues.RESULTS: Significantly fewer perineural adhesions were found in animals treated with ACP gel (high viscosity) and Adcon-T/N compared with controls. Quantitative histological analysis revealed a statistically significant reduction in the amount of scar tissue surrounding the nerves treated with ACP gel. No evidence of toxicity was found, and the gel did not interfere with nerve regeneration (counts of regenerating myelinated axons).CONCLUSION: ACP gel with high viscosity seems to be safe and effective in reducing perineural adhesions and scar formation after peripheral nerve surgery.