Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis

Abstract

Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis 1 4-Experimental SurgeryActa Cir Bras. 2017;32(3):287-296 Abstract Purpose: To compare the functional result of standart vein grafts and inside-out vein graft technique on sciatic nerve repair. Methods: We used 24 male Wistar rats divided into 4 groups: control group (CG), standard vein graft group (SVG), Inside-out vein graft group (IOVG) and denervated Group (DG). SVG, IOVG and DG underwent total section of the sciatic nerve, SVG and IOVG however underwent nerve repair surgery using a graft with normal jugular vein and inside-out jugular vein, respectively. Histological analysis of the soleus and Extensor Digitorum Longus (EDL), and Sciatic Functional Index were used to compare the results after 6 weeks. Results: Both grafts acted favorably in muscle recovery and improved functionality; They were similar in all parameters, however, in more points SVG achieved similar to the CG, in the other hand IOVG more times was similar to DG. Fact that makes the graft with normal vein the most viable option between the two options. Conclusion: Both types of grafts acted beneficially wherein the graft normal vein has proved to be the best option 287Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis Bueno CRS et al. Acta Cir Bras. 2017;32(3):287-296 288 For this purpose, the adhesion of the rat as an animal model was based on the fact that its physiological profile, its morphological structure and the biological processes involved in the nerve regeneration are quite similar to that of the human being, being a suitable model for this investigation 14 . The purpose of this study was to compare the muscular and functional results after sciatic nerve repair with the tubulization technique using the normal vein graft and the reverse vein graft, in order to determine the most favorable surgical option. ■ MethodsThe study was approved under the protocol 032/2011 by the Ethics Committee, Faculty of Dentistry of Bauru, Universidade de São Paulo.Were used twenty-four male Wistar rats with 60 days of life in collective storage, with no restrictions on movement, respecting cycles of 12 hours of light / dark and average ambient temperature of 24°C. The animals were divided into four groups (n=6 each). Control Group (CG) and three experimental groups: Denervate Group (DG), Inside-Out Vein Graft (IOVG) and Standart Vein Graft (SVG). In all groups the right pelvic limb was used for the experimental study. The IOVG and SVG groups received autologous venous graft from the left jugular vein, but for the IOVG group, the jugular vein was inverted. Surgical proceduresThe animals were anesthetized with a combination of Ketamine Hydrochloride (Dopalen ® ) and Xilazine Hydrochloride (Anasedan ® ), administered intramuscularly at a dose of 0.10 ml/100g body weight in the dorsolateral region of the left hind paw. Subsequen...

Inside-out and standard vein grafts associated with platelet-rich plasma (PRP) in sciatic nerve repair. A histomorphometric study

“…The choice of the venous tubulization technique associated with cell therapy, In this experiment, demonstrated better histomorphological and histomorphometric results in the vein filled with Platelet Rich Plasma groups (SVPRP e IOVPRP), coinciding with some authors who used other types of filling [13][14][15][16] . Thus, it can be suggested that the filling of the vein with biological materials, prevent venous lumen collapse, allowing for better biochemical communication between the nervous stumps, and thus favoring the axonal growth 4 .…”

“…In theory, in cases of peripheral nerve damage such as neuropraxia or axonotmosis, where there was no complete rupture of the nerve, the presence of the neurovascular bundle in contact with the adventitia would provide a favorable microenvironment that could contribute to the repair process 16 . Thus, it can be suggested that laminin and the tunica adventitial, rich in collagen and trophic factors, in direct contact with the axons were not decisive to provide higher histomorphometric results compared to the standard technique 21,22 .…”

Application of epineural sheath conduit for restoration of 6‐cm long nerve defects in a sheep median nerve model

“…Due to its biomechanical properties, ES protects and facilitates axonal regeneration, and thus was previously used in peripheral nerve repair as a conduit or sleeve in the rat and rabbit models (Ayhan, Markal, Siemionow, Araneo, & Siemionow, 2003;Ayhan, Yavuzer, Latifo glu, & Atabay, 2000;FIGURE 4 Comparison of the maximal nerve conduction velocity-NCV (A) and somatosensory evoked potentials-SSEP (B) results between autograft controls (group 2, n = 4 nerves/group) and epineural sheath conduit (group 3, n = 4 nerves/group) at 6 months after sheep median nerve repair FIGURE 5 Representative images of toluidine blue staining of a distal segment of autograft controls (panel A) and epineural sheath conduit (panel B) at 6 months after sheep median nerve repair confirmed presence of myelinated axons Demirkan, Snyder, Latifoglu, & Siemionow, 1995;Karacaoglu, Yüksel, Peker, & Güler, 2001). Compared to other naturally occurring biomaterials, such as vein (Bueno et al, 2017;Nijhuis et al, 2013), artery (Itoh et al, 1996), muscle (Battiston, Tos, Conforti, & Geuna, 2007;Nijhuis et al, 2013), or bone (IJpma, Van De Graaf, & Meek, 2008), ES is the only material of the neural origin. This represents a potential advantage of the ESC over other natural and synthetic conduits, due to a high laminin expression (Siemionow et al, 2011), which provides neuropermissive microenvironment and facilitates Schwann cell attachment and axonal regeneration (Siemionow & Brzezicki, 2009;Siemionow, Bozkurt, & Zor, 2010).…”

“…Due to its biomechanical properties, ES protects and facilitates axonal regeneration, and thus was previously used in peripheral nerve repair as a conduit or sleeve in the rat and rabbit models (Ayhan, Markal, Siemionow, Araneo, & Siemionow, ; Ayhan, Yavuzer, Latifoğlu, & Atabay, ; Demirkan, Snyder, Latifoglu, & Siemionow, ; Karacaoglu, Yüksel, Peker, & Güler, ). Compared to other naturally occurring biomaterials, such as vein (Bueno et al, ; Nijhuis et al, ), artery (Itoh et al, ), muscle (Battiston, Tos, Conforti, & Geuna, ; Nijhuis et al, ), or bone (IJpma, Van De Graaf, & Meek, ), ES is the only material of the neural origin. This represents a potential advantage of the ESC over other natural and synthetic conduits, due to a high laminin expression (Siemionow et al, ), which provides neuropermissive microenvironment and facilitates Schwann cell attachment and axonal regeneration (Siemionow & Brzezicki, ; Siemionow, Bozkurt, & Zor, ).…”

Comunicação exossomal na transdiferenciação de células-tronco em cocultivo com células neuronais

“…A principal consequência da lesões de nervo periférico (PNI -sigla em inglês para peripheral nerve injury) é a perda definitiva da função do membro ou local afetado, sendo que muitas vezes o uso de transplante de nervo do próprio paciente, assim como a utilização de biomateriais em conjunto ou não com células-tronco, se tornam uma alternativa na busca da regeneração e retorno da função (BUENO et al, 2017;COONEY et al, 2016;GÄRTNER et al, 2014;HEI et al, 2017;MARCONI et al, 2012;ZHANG, T. et al, 2014;WANG et al, 2010;WANG et al, 2017).…”