Evaluation of two biodegradable nerve guides for the reconstruction of the rat sciatic nerve.

The purpose of this study was to test in vivo two different nerve guides, one of PLGA made of a novel proportion (90:10) of the two polymers, Poly(L-lactide):Poly(glycolide), with (DL-lactide-epsilon-caprolactone) copolyester (Neurolac) tube, in promoting nerve regeneration across a 10 mm-gap of the rat sciatic nerve. Finally, end-to-end coaptation was performed. Motor and sensory functional recovery was assessed throughout the healing period of 20 weeks and the repaired nerves were processed for morphological analysis. Both motor and sensory functions improved significantly in all experimental nerve repair groups, although the rate and extent of recovery was significantly higher in the end-to-end group. No significant differences were detected in the comparison between the two types of tubes. Compatible with results of functional tests, morphological analysis showed that axon regeneration occurred in both PLGA and Neurolac experimental groups but disclosed a different pattern of degradation of the two types of tubes with larger biodegradation of PLGA material by the end of 20 weeks. These results suggest that both types of biomaterial are a good substrate for preparing tubular nerve guides and the different pattern of degradation does not seem to influence the degree of nerve regeneration.

[1]  P. Richardson,et al.  Peripheral nerve injury , 1994, Current opinion in neurology.

[2]  Marcel F Meek,et al.  In vitro degradation and biocompatibility of poly(DL-lactide-epsilon-caprolactone) nerve guides. , 2004, Journal of biomedical materials research. Part A.

[3]  J. Swett,et al.  Motor versus Sensory Neuron Regeneration through Collagen Tubules , 1998, Plastic and reconstructive surgery.

[4]  R. Langer,et al.  Prolonged Regional Nerve Blockade by Controlled Release of Local Anesthetic from a Biodegradable Polymer Matrix , 1993, Anesthesiology.

[5]  P. Tos,et al.  Use of muscle‐vein‐combined Y‐chambers for repair of multiple nerve lesions: Experimental results , 2004, Microsurgery.

[6]  M. May.  Trauma to the facial nerve. , 1983, Otolaryngologic clinics of North America.

[7]  Pedro Melo-Pinto,et al.  Methods for the experimental functional assessment of rat sciatic nerve regeneration , 2004, Neurological research.

[8]  M. Meek,et al.  Functional assessment of sciatic nerve recovery: biodegradable poly (DLLA‐ϵ‐CL) nerve guide filled with fresh skeletal muscle , 2003, Microsurgery.

[9]  W. D. den Dunnen,et al.  Long-term evaluation of degradation and foreign-body reaction of subcutaneously implanted poly(DL-lactide-epsilon-caprolactone). , 1997, Journal of biomedical materials research.

[10]  D. Winter,et al.  Ankle kinematics to evaluate functional recovery in crushed rat sciatic nerve , 2003, Muscle & nerve.

[11]  M. Meek,et al.  Morphology of nerve fiber regeneration along a biodegradable poly (DLLA‐ϵ‐CL) nerve guide filled with fresh skeletal muscle , 2003, Microsurgery.

[12]  P H Robinson,et al.  Poly(DL‐lactide‐ϵ‐caprolactone) nerve guides perform better than autologous nerve grafts , 1996, Microsurgery.

[13]  T. Hadlock,et al.  Quantification of Functional Recovery Following Rat Sciatic Nerve Transection , 2001, Experimental Neurology.

[14]  G. Lundborg.  Alternatives to autologous nerve grafts. , 2004, Handchirurgie, Mikrochirurgie, plastische Chirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Handchirurgie : Organ der Deutschsprachigen Arbeitsgemeinschaft fur Mikrochirurgie der Peripheren Nerven und Gefasse : Organ der V....

[15]  H. Millesi.  Progress in peripheral nerve reconstruction , 1990, World Journal of Surgery.

[16]  Marcel F Meek,et al.  A prospective clinical evaluation of biodegradable neurolac nerve guides for sensory nerve repair in the hand. , 2005, The Journal of hand surgery.

[17]  S. Mackinnon,et al.  The Role of Conduits in Nerve Repair: A Review , 1996, Reviews in the neurosciences.

[18]  F. Rodrı́guez,et al.  Regeneration and functional recovery following peripheral nerve injury , 2004 .

[19]  P H Robinson,et al.  Long‐term evaluation of functional nerve recovery after reconstruction with a thin‐walled biodegradable poly (DL‐Lactide‐ϵ‐caprolactone) nerve guide, using walking track analysis and electrostimulation tests , 1999, Microsurgery.

[20]  D. Kline.  Spinal nerve root repair after brachial plexus injury. , 2000, Journal of neurosurgery.

[21]  J. Campbell.  Nerve lesions and the generation of pain , 2001, Muscle & nerve.

[22]  G. Lundborg.  Enhancing posttraumatic nerve regeneration , 2002, Journal of the peripheral nervous system : JPNS.

[23]  R. Tranquillo,et al.  Guided Neurite Elongation and Schwann Cell Invasion into Magnetically Aligned Collagen in Simulated Peripheral Nerve Regeneration , 1999, Experimental Neurology.

[24]  B. Bershadsky,et al.  Neurologic Evaluation of the Rat during Sciatic Nerve Block with Lidocaine , 1995, Anesthesiology.

[25]  Stefano Geuna,et al.  Use of skeletal muscle tissue in peripheral nerve repair: review of the literature. , 2004, Tissue engineering.

[26]  Mark Ellisman,et al.  Nerve regeneration through artificial tubular implants , 1989, Progress in Neurobiology.

[27]  A. Seifalian,et al.  Artificial nerve conduits in peripheral‐nerve repair , 2005, Biotechnology and applied biochemistry.

[28]  C. Berde,et al.  Neurologic Evaluation of Infant and Adult Rats before and after Sciatic Nerve Blockade , 1997, Anesthesiology.

[29]  S. Mackinnon,et al.  Histologic Assessment of Nerve Regeneration in the Rat , 1985, Plastic and reconstructive surgery.

[30]  Christine E Schmidt,et al.  Neural tissue engineering: strategies for repair and regeneration. , 2003, Annual review of biomedical engineering.

[31]  M. Brenner,et al.  Use of anti‐CD40 ligand monoclonal antibody as antirejection therapy in a murine peripheral nerve allograft model , 2004, Microsurgery.

[32]  R. Midha,et al.  Peripheral nerve repair and grafting techniques: a review. , 2000, Neurologia medico-chirurgica.

[33]  Bridging nerve defects - the role of tissue interpositioning , 2004 .

[34]  Stefano Geuna,et al.  Nerve repair by means of tubulization: Literature review and personal clinical experience comparing biological and synthetic conduits for sensory nerve repair , 2005, Microsurgery.