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

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)
Publication Information
Archives of Plastic Surgery / v.34, no.3, 2007 , pp. 279-284 More about this Journal
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
Nerve regeneration; Vein graft; Hyaluronic acid;
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1 Chiu DT, Janecka I, Krizek TJ, Wolff M, Lovelace RE: Autogenous vein graft as a conduit for nerve regeneration. Surgery 91: 226, 1982
2 Kong JM, Zhong SZ, Bo S, Zhu SX: Experimental study of bridging the peripheral nerve gap with skeletal muscle. Microsurgery 7: 183, 1986
3 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
4 Trumble TE, McCallister WV: Repair of peripheral nerve defects in the upper extremity. Hand Clin 16: 37, 2000
5 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
6 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
7 Nathason MA: Hyaluronates in developing skeletal tissues. Clin Orthop Relat Res 251: 275, 1990
8 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
9 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
10 Suematsu N, Atsuta Y Hirayama T: Vein graft for repair of peripheral nerve gap. J Reconstr Microsurg 4: 313, 1988
11 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
12 Finseth F, Constable JD, Cannon B: Interfascicular nerve grafting. early experiences at the Massachusetts General Hospital. Plast Reconstr Surg 56: 492, 1975
13 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