Novel Polysaccharide‐derived hydrogel prevents perineural adhesions in a rat model of sciatic nerve adhesion

Abstract

ABSTRACT:We investigated the effects of a novel carboxymethylcellulose (CMC)-derived hydrogel, in which phosphatidylethanolamine (PE) was introduced into the carboxyl groups of CMC, for preventing perineural adhesion after extensive internal neurolysis of rat sciatic nerve. Sciatic nerves were randomly assigned to one of the following groups: the Control group, operated but no treatment; the HA group, operated and treated with 1% hyaluronan; the CMC-PE(L) group, operated and treated with low-viscosity CMC-PE hydrogel; and the CMC-PE(H) group, operated and treated with high-viscosity CMC-PE hydrogel. Perineural adhesions were evaluated at 6 weeks. Nerves were also subjected to biomechanical testing to assess ultimate breaking strength. Electrophysiological and wet muscle weight measurements were performed. Breaking strengths were significantly lower for the CMC-PE(L) group than for the Control and HA groups. Latency was significantly longer for the Control group than for the CMC-PE(L) group at 20 days. The mean percentage of wet muscle weight to body weight was significantly lower for the Control group than for the CMC-PE(L) group at 6 weeks. Low-viscosity CMC-PE hydrogel appears to prevent perineural adhesions and allow early restoration of nerve function. ß

A simple and reliable method to perform biomechanical evaluation of postoperative nerve adhesions

“…Although our biomechanical results are similar to those obtained in previous studies that applied biomechanical evaluation to assess perineural scar formation in larger animal models (Ikeda et al 2003, Smit et al 2004, Yamamoto et al 2009, it should be pointed out that we registered higher standard deviation in all groups due to the smaller size of the nerve in mice and consequent lower tensile strength. However, in spite of the higher variance, our set of biomechanical data allowed to detect significant differences between groups and the experimental protocol will thus allow to assess the effectiveness of various anti-adherential treatments, such as chemical agents and adipose-derived stem cells.…”

“…Finally, while rats (Zuijdendorp et al 2008, Yamamoto et al 2009 and rabbits (Ikeda et al 2003, Abe et al 2005 have been mainly used so far for nerve scar investigation, we were able to show that methods for scar induction are adaptable also to the mouse, namely the most widely used rodent experimental model, opening interesting research perspectives due to the large availability of genetically modified mice (Tos 2008). …”

“…To prevent this pathological condition, various treatment strategies have been proposed as barriers against perineural adhesions that can be applied after nerve surgery (Smit et al 2004, Ilbay et al 2004, Dam-Hieu et al 2005, Abe et al 2005, Yamamoto et al 2009. Whereas various techniques and protocols have been described to induce a perineural scar in experimental models for the preclinical testing of anti-adherence procedures, a recognized standardized protocol has not been defined yet (Smit et al 2004).…”

“…An original instrument adapted from previously ones was developed (Figure 2a) (Ikeda et al 2003, Smith et al 2004, Abe et al 2005, Zuijdendorp et al 2008, Yamamoto et al 2009. The sciatic nerve was exposed near to the origin and loaded with 9-0 Nylon suture at the beginning of scar tissue (Fig 2b). 7 Then, the suture was connected to a plastic can by a simple knot.…”

The Effect of Silicone Tube and Silicone Tube + Hyaluronic Acid Application on Adhesion Formation in Experimental Peri- and Epi-neurorrhaphy in A Rat Model

“…In addition, various organic and synthetic membranes or tube practices have been used so as to prevent adhesion to surrounding tissues and eliminate mechanical pressures and extensions on nerves [1][2][3][4][6][7][8][9][10][11] .…”