Nerve Regeneration Using a Vein Graft Conduit filled with Hyaluronic Acid in a Rat Model

흰쥐 모델에서 하이알루론산을 채운 정맥도관의 신경재생에 관한 연구

  • Suh, Bo Ik (Department of Plastic and Reconstructive Surgery, Kyungpook National University) ;
  • Kim, Sang Woo (Department of Plastic and Reconstructive Surgery, Pochon Cha University) ;
  • Chung, Ho Yun (Department of Plastic and Reconstructive Surgery, Kyungpook National University) ;
  • Kim, Il Hwan (Department of Plastic and Reconstructive Surgery, Kyungpook National University) ;
  • Yang, Jung Dug (Department of Plastic and Reconstructive Surgery, Kyungpook National University) ;
  • Park, Jae Woo (S-Jelim Plastic Surgery and Aesthetic clinic) ;
  • Cho, Byoung Chae (Department of Plastic and Reconstructive Surgery, Kyungpook National University)
  • 서보익 (경북대학교 의과대학 성형외과학교실) ;
  • 김상우 (포천중문 의과대학 성형외과학교실) ;
  • 정호윤 (경북대학교 의과대학 성형외과학교실) ;
  • 김일환 (경북대학교 의과대학 성형외과학교실) ;
  • 양정덕 (경북대학교 의과대학 성형외과학교실) ;
  • 박재우 (S-제림 성형외과) ;
  • 조병채 (경북대학교 의과대학 성형외과학교실)
  • Received : 2007.01.03
  • Published : 2007.05.10

Abstract

Purpose: The vein graft was considered as a useful conduit for nerve defect. But the problem is that it might be collapsed in long vein graft state. A new experimental model using vein graft filled with hyaluronic acid was considered. Methods: Thirty rats were used for the experimental animal. In group I, one side of the femoral nerve was exposed and a segment was removed about 15mm. The neural gap was connected with nerve graft. In group II, the nerve gap was connected with vein graft only. In group III, the nerve gap was connected with vein graft filled with hyaluronic acid. A walking track analysis was made periodically for 2 months and NCV(nerve conduction velocity) was executed at the end of the experiment. And morphologic studies were also done for all groups Results: In a walking track analysis, the toe-spread was widen and the foot-length was lengthened. The recovery of the toe-spread and foot length was checked 2 weeks interval, periodically for two months. The SFI (sciatic function index) was $-52.5{\pm}8.2$ in group I, $-68.1{\pm}4$ in group II, $-55.3{\pm}7.9$ in group III. In electrophysiological study, NCV(nerve conduction velocity) was $26.71{\pm}3.11m/s$ in group I, $17.94{\pm}4.35m/s$ in group II, $25.69{\pm}2.81m/s$ in group III. The functional recovery in group I and III was superior to that the group II statistically(p < 0.05) Under electromicroscopic study, the number of the myelinated axons were $1419.1{\pm}240$ in group I, $921.7{\pm}176.8$ in group II, $1322.2{\pm}318$ in group III. The number of the myelinated axons were much more in group I and III than group II statistically (p<0.05). Conclusion: This study suggested that the vein graft filled with hyaluronic acid is more effective than vein graft only for the conduit of the nerve gap. It was thought that the technique could be used in clinical cases with nerve defects as an alternative method to classical nerve grafts.

Keywords

References

  1. Finseth F, Constable JD, Cannon B: Interfascicular nerve grafting. early experiences at the Massachusetts General Hospital. Plast Reconstr Surg 56: 492, 1975
  2. Walton RL, Brown RE, Matory WE Jr, Borah GL, Dolph JL: Autogenous vein graft repair of digital nerve defects in the finger: A retrospective clinical study. Plast Reconstr Surg 84: 944, 1989
  3. Trumble TE, McCallister WV: Repair of peripheral nerve defects in the upper extremity. Hand Clin 16: 37, 2000
  4. Battiston BD, Tos P, Cushway TR, Geuna S: Nerve repair by means of vein filled with muscle grafts: I. Clinical results. Microsurgery 20: 32, 2000
  5. Wang KK, Costas PD, Bryan DJ, Eby PL, Seckel BR: Inside-out vein graft repair compared with nerve grafting for nerve regeneration in rats. Microsurgery 16: 65, 1995
  6. Weber RA, Breidenbach WC, Brown RE, Jabaley ME, Mass DP: A randomized prospective study of polyglycolic acid conduits for digital nerve reconstruction in humans. Plast Reconstr Surg 106: 1036, 2000
  7. Chiu DT, Janecka I, Krizek TJ, Wolff M, Lovelace RE: Autogenous vein graft as a conduit for nerve regeneration. Surgery 91: 226, 1982
  8. Kong JM, Zhong SZ, Bo S, Zhu SX: Experimental study of bridging the peripheral nerve gap with skeletal muscle. Microsurgery 7: 183, 1986
  9. Dellon AL, Mackinnon SE: An alternative to the classical nerve graft for the management of the short nerve gap. Plast Reconstr Surg 82: 849, 1988
  10. Bain JR, Mackinnon SE, Hunter DA: Functional evaluation of complete sciatic, peroneal, and posterior tibial nerve lesions in the rat. Plast Reconstr Surg 83: 129, 1989
  11. Danielsen N, Dahlin LB, Lee YF, Lundborg G: Axonal growth in mesothelial chambers. The role of the distal nerve segment. Scand J Plast Reconstr Surg 17: 119, 1983
  12. Suematsu N, Atsuta Y Hirayama T: Vein graft for repair of peripheral nerve gap. J Reconstr Microsurg 4: 313, 1988
  13. Nathason MA: Hyaluronates in developing skeletal tissues. Clin Orthop Relat Res 251: 275, 1990