Peripheral nerve reconstruction with collagen tubes filled with denatured autologous muscle tissue in the rat model

Abstract

Conventional nerve conduits lack cellular and extracellular guidance structures critical for bridging larger defects. In this study, an exogenous matrix for axonal regeneration was provided by pretreated muscle tissue. In 24 rats, 14-mm sciatic nerve segments were resected and surgically reconstructed using one of the following methods: autograft (AG); bovine type I collagen conduit; (MDM) collagen tube filled with modified denatured autologous muscle tissue. For 8 weeks, functional regeneration was evaluated by footprint and video gait analysis. Evaluation was complemented by electrophysiology, as well as qualitative and quantitative structural assessment of nerves and target muscles. Group AG was superior both structurally and functionally, showing higher axon counts, a more normal gait pattern, and less severe muscle atrophy. Fiber quality (fiber size and myelin thickness) was highest in group MDM, possibly related to the myelin-producing effect of muscular laminin. However, axon count was lowest in this group, and ultrastructural analysis of the denatured muscle tissue showed areas of incomplete denaturation that had acted as a mechanical barrier for regenerating axons. In light of these results, the often advocated use of muscular exogenous matrix for peripheral nerve reconstruction is reviewed in the literature, and its clinical application is critically discussed. In conclusion, combined muscle tubes may have a positive influence on nerve fiber maturation. However, muscle pretreatment is not without risks, and denaturation processes need to be further refined.

Comparison between suture and fibrin glue on repair by direct coaptation or tubulization of injured mouse sciatic nerve

“…In this study, we have used collagen tubes, already tested for biocompatibility and absorption . to serve as a guide for the axon regeneration.…”

“…Different conduits have been used to bridge nerve gaps, using biological and nonbiological tubular nerve guides. The biodegradable polymers have the advantage of avoiding a second surgery to remove them, and also preserve a healthy nerve …”

Comparison of repair of peripheral nerve transection in predegenerated muscle with and without a vein graft

“…The resected gluteus muscle was denatured by submerging it in liquid nitrogen for 50 s. Then it was thawed in distilled water for 3 min [17]. Under an operating microscope, the proximal and distal of the epineurium nerve ends were sutured to the epimysium of the muscle with 10–0 nylon, creating an endomysial tube in which the proximal and distal ends of the sciatic nerve were separated by 10 mm [15].…”

Progress of nerve bridges in the treatment of peripheral nerve disruptions

“…Biological conduits such as autologous arteries, veins, muscles, 33 and umbilical cord vessels have been widely used to repair relatively short nerve defects. These materials can provide support for the nerve in the short term and degrade to innocuous products after complete nerve regeneration.…”