■对于神经损伤,不能对神经无张力的神经外膜接合,自体移植是首选治疗方法。虽然可吸收缝合线不推荐用于神经修复,没有证据表明非吸收性缝线优于可吸收性缝线.本研究旨在评估非吸收性单丝尼龙缝线的有效性,可吸收单丝vicryl缝线,和用于神经移植的纤维蛋白胶。
■Lewis大鼠(N=32)接受坐骨神经横断,并随机分配到一组:用尼龙移植,用Vicryl移植,用纤维蛋白胶移植,或者没有移植。电机功能,感觉功能,在12周的恢复期中评估了热痛,和免疫组织化学用于评估巨噬细胞反应。
■在12周时,Vicryl和Nylon组的脚踝角度明显更大,这是运动功能的量度,与受伤对照组相比(p<0.05)。与未受伤的后肢相比,移植的大鼠在热响应方面没有差异,但对机械刺激具有超敏反应。尼龙,Vicryl,与损伤对照组相比,纤维蛋白胶组的腓肠肌萎缩均显著较少(p<0.0001)。在纤维蛋白胶组中,3/9移植物未合并。与Vicryl组相比,尼龙组的缝合孔周围轴突生长明显减少(p=0.0004)。轴突数没有差异,运动神经元,或所有移植大鼠之间的感觉神经元。
■这些结果表明,对于损伤和移植后的神经恢复,vicryl缝线的作用与尼龙一样好。
UNASSIGNED: For nerve injuries, not amendable to tensionless epineural coaptation of the nerve, autografts are the preferred treatment. Although absorbable sutures are not recommended for nerve repair, there is no evidence that non-absorbable sutures are superior to absorbable sutures. This study aims to assess the effectiveness of non-absorbable monofilament nylon sutures, absorbable monofilament vicryl sutures, and fibrin glue when used for nerve grafting.
UNASSIGNED: Lewis rats (N = 32) were subjected to a sciatic nerve transection and randomly assigned to a group: graft with Nylon, graft with Vicryl, graft with Fibrin Glue, or no graft. Motor function, sensory function, and thermal pain were assessed during a 12-week recovery period, and immunohistochemistry was used to assess macrophage response.
UNASSIGNED: At 12 weeks, the Vicryl and Nylon groups had significantly larger ankle angles at to lift off, which is a measure of motor function, compared to injured controls (p < 0.05). Grafted rats displayed no difference in thermal response but hypersensitivity to mechanical stimuli compared to the uninjured hindlimb. The Nylon, Vicryl, and Fibrin Glue groups all had significantly less atrophy of the gastrocnemius muscle compared to injured controls (p < 0.0001). In the Fibrin Glue group, 3/9 grafts did not incorporate. The Nylon group had significantly less (p = 0.0004) axon growth surrounding the suture holes compared to the Vicryl group. There were no differences in the axon counts, motor neurons, or sensory neurons between all grafted rats.
UNASSIGNED: These results demonstrate that vicryl sutures work just as well as nylon for nerve recovery after injury and grafting.