Inside‐outl vein graft repair compared with nerve grafting for nerve regeneration in rats

Abstract

The inside-out vein graft is a vein conduit pulled through itself to invert the normal orientation and place the adventitial layer within the lumen of the conduit. Our study compares regeneration of peripheral nerves in the rat through two conduits: inside-out graft of the jugular vein and autogenous nerve graft. In 10 rats, the right jugular vein was harvested, turned inside out, and used to bridge a 10 mm defect created in the right sciatic nerve. The 10 mm nerve segment from the right was then used as a standard nerve graft to bridge a 10 mm gap created in the left sciatic nerve. Rats were sacrificed at 8 and 12 weeks. Regeneration on the inside-out vein graft side showed superior functional results (faster conduction velocities) and improved histological results (greater axon counts) compared with the nerve grafted side. We feel the adventitial surface of the wall of the vein promotes nerve regeneration by providing an environment rich with collagen, laminin, and Schwann cells and promotes increased vascularization of the new nerve.

Effects of Chitosan-Zinc Oxide Nanocomposite Conduit on Transected Sciatic Nerve: An Animal Model Study

“…Entubulation neurorrhaphy is an excellent alternative to short interposition nerve grafts [24]. Selection of an appropriate method to evaluate functional recovery of nerve regeneration is extremely influential.…”

Effects of topically administered FK506 on sciatic nerve regeneration and reinnervation after vein graft repair of short nerve gaps

“…18 Vein grafting has shown promising results in directing axons from the proximal to the distal stump and creating a local microenvironment. 25,30 The development of therapeutic agents that can promote the rate of nerve regeneration and enhance the degree of functional recovery after injury is important. By accelerating axonal regeneration, such agents could diminish the consequences of denervation on target organs (muscle atrophy, loss of sensory receptors, and denervation hypersensitivity) and result in more efficient functional recovery (following reinnervation).…”

Local Administration of Nimodipine and Improvement of Functional Recovery of the Transected Sciatic Nerve after Bridging with Inside-out Artery Graft

“…An artery graft presents large quantities of laminin and some collagen. These substances are also found in Schwann-cell basal membrane and are reported as axonal outgrowth factors (Ferrari et al, 1999;Ide et al, 1983;Itoh et al, 1996;Lander Fujii 1985;Wang et al, 1993;Wang et al, 1995). Laminin, one of the main basal membrane components, stimulates neurite outgrowth, induces Schwann-cell mitosis, and plays a fundamental role in peripheral nerve regeneration Tohyama and Ide 1984).…”

“…As well as requiring nerve fiber contact, normal Schwann-cell differentiation requires contact with a connective tissue matrix or some associated material such a collagen (Bunge and Bunge 1978). Standard artery graft basal membrane tube diameter is large, and the contact surface for migrating Schwann cell or axonal outgrowth cone adhesion becomes very small (Wang et al, 1995;Barcelos et al, 2003). Nevertheless, in inside-out artery grafts, this negative effect might be diminished once the adventitia provides a permissive matrix which increases the contact surface for axons (Barcelos et al, 2003).…”