PDF(Pubmed)
Abstract：
Photochemical sealing of a nerve wrap over the repair site isolates and optimizes the regenerating nerve microenvironment. To facilitate clinical adoption of the technology, we investigated photosealed autologous tissue in a rodent sciatic nerve transection and repair model. Rats underwent transection of the sciatic nerve with repair performed in three groups: standard microsurgical neurorrhaphy (SN) and photochemical sealing with a crosslinked human amnion (xHAM) or autologous vein. Functional recovery was assessed at four-week intervals using footprint analysis. Gastrocnemius muscle mass preservation, histology, and nerve histomorphometry were evaluated at 120 days. Nerves treated with a PTB-sealed autologous vein improved functional recovery at 120 days although the comparison between groups was not significantly different (SN: -58.4 +/- 10.9; XHAM: -57.9 +/- 8.7; Vein: -52.4 +/- 17.1). Good muscle mass preservation was observed in all groups, with no statistical differences between groups (SN: 69 +/- 7%; XHAM: 70 +/- 7%; Vein: 70 +/- 7%). Histomorphometry showed good axonal regeneration in all repair techniques. These results demonstrate that peripheral nerve repair using photosealed autologous veins produced regeneration at least equivalent to current gold-standard microsurgery. The use of autologous veins removes costs and foreign body concerns and would be readily available during surgery. This study illustrates a new repair method that could restore normal endoneurial homeostasis with minimal trauma following severe nerve injury.
摘要：
修复部位上的神经包裹物的光化学密封可隔离并优化再生神经微环境。为了促进该技术的临床采用，我们研究了啮齿动物坐骨神经横断和修复模型中的光密封自体组织。对大鼠进行坐骨神经横切，并进行三组修复：标准的显微外科神经修补术（SN）和用交联的人羊膜（xHAM）或自体静脉进行光化学密封。使用足迹分析以四周间隔评估功能恢复。腓肠肌质量保存，组织学,在120天评估和神经的组织形态计量学。用PTB密封的自体静脉治疗的神经在120天改善了功能恢复,尽管组间比较没有显著差异(SN:-58.4+/-10.9;XHAM:-57.9+/-8.7;静脉:-52.4+/-17.1)。各组肌肉质量保存良好，组间无统计学差异(SN:69+/-7%;XHAM:70+/-7%;静脉:70+/-7%)。组织形态计量学在所有修复技术中均显示出良好的轴突再生。这些结果表明，使用光封自体静脉进行的周围神经修复产生的再生至少等同于当前的金标准显微外科手术。自体静脉的使用消除了成本和异物问题，并且在手术期间很容易获得。这项研究说明了一种新的修复方法，该方法可以在严重神经损伤后以最小的创伤恢复正常的神经内膜稳态。
