Comparison between Flexible Collagen and Vein Conduits Used for Size-Discrepant Nerve Repair: An Experimental Study in Rats

Abstract

Primary nerve repair is the gold standard in nerve reconstruction. When primary repair is not possible for injured nerves, conduit-assisted repair methods are frequently used. As conduits, autologous vein segments or allogenic biodegradable products can be used. However, their effectiveness when used in a nerve defect where a size discrepancy exists has not been compared. In this study, either a vein graft or a synthetic collagen conduit was used to bridge 10-mm defects between size-discrepant tibial and peroneal nerves in a rat model. After 90 days, nerve regeneration was evaluated using electrophysiological and histological methods. It can be concluded based on the results of this study that bridging a 10-mm nerve gap with synthetic collagen conduits and autologous vein grafts yielded similar results in small-to-large nerve coaptations, with the vein graft being slightly more effective.

Keywords

size discrepancy - collagen conduit - vein conduit

• References

• 1 Goto E, Mukozawa M, Mori H, Hara M. A rolled sheet of collagen gel with cultured Schwann cells: model of nerve conduit to enhance neurite growth. J Biosci Bioeng 2010; 109 (5) 512-518
• 2 Lundborg G. A 25-year perspective of peripheral nerve surgery: evolving neuroscientific concepts and clinical significance. J Hand Surg Am 2000; 25 (3) 391-414
• 3 Meek MF, Coert JH. Clinical use of nerve conduits in peripheral-nerve repair: review of the literature. J Reconstr Microsurg 2002; 18 (2) 97-109
• 4 Pettersson J, Kalbermatten D, McGrath A, Novikova LN. Biodegradable fibrin conduit promotes long-term regeneration after peripheral nerve injury in adult rats. J Plast Reconstr Aesthet Surg 2010; 63 (11) 1893-1899
• 5 Acar M, Karacalar A, Ayyildiz M , et al. The effect of autogenous vein grafts on nerve repair with size discrepancy in rats: an electrophysiological and stereological analysis. Brain Res 2008; 1198: 171-181
• 6 Penna V, Wewetzer K, Munder B, Stark GB, Lang EM. The long-term functional recovery of repair of sciatic nerve transection with biogenic conduits. Microsurgery 2012; 32 (5) 377-382
• 7 Swett JE, Torigoe Y, Elie VR, Bourassa CM, Miller PG. Sensory neurons of the rat sciatic nerve. Exp Neurol 1991; 114 (1) 82-103
• 8 Viterbo F, Trindade JC, Hoshino K, Mazzoni A. Two end-to-side neurorrhaphies and nerve graft with removal of the epineural sheath: experimental study in rats. Br J Plast Surg 1994; 47 (2) 75-80
• 9 Taras JS, Nanavati V, Steelman P. Nerve conduits. J Hand Ther 2005; 18 (2) 191-197
• 10 Ozcan G, Shenaq S, Spira M. Vascularized nerve tube: an experimental alternative for vascularized nerve grafts over short gaps. J Reconstr Microsurg 1993; 9 (6) 405-413
• 11 Dahlin LB, Lundborg G. Use of tubes in peripheral nerve repair. Neurosurg Clin N Am 2001; 12 (2) 341-352
• 12 Jiang X, Lim SH, Mao HQ, Chew SY. Current applications and future perspectives of artificial nerve conduits. Exp Neurol 2010; 223 (1) 86-101
• 13 Yao L, de Ruiter GC, Wang H , et al. Controlling dispersion of axonal regeneration using a multichannel collagen nerve conduit. Biomaterials 2010; 31 (22) 5789-5797
• 14 Cemil B, Ture D, Cevirgen B, Kaymaz F, Kaymaz M. Comparison of collagen biomatrix and omentum effectiveness on peripheral nerve regeneration. Neurosurg Rev 2009; 32 (3) 355-362 , discussion 362
• 15 Canan S, Bozkurt HH, Acar M , et al. An efficient stereological sampling approach for quantitative assessment of nerve regeneration. Neuropathol Appl Neurobiol 2008; 34 (6) 638-649
• 16 Alkan A, Inal S, Yildirim M, Baş B, Ağar E. The effects of hemostatic agents on peripheral nerve function: an experimental study. J Oral Maxillofac Surg 2007; 65 (4) 630-634
• 17 Larsen JO. Stereology of nerve cross sections. J Neurosci Methods 1998; 85 (1) 107-118
• 18 Zhang P, Han N, Wang T , et al. Biodegradable conduit small gap tubulization for peripheral nerve mutilation: a substitute for traditional epineurial neurorrhaphy. Int J Med Sci 2013; 10 (2) 171-175
• 19 Strauch B, Rodriguez DM, Diaz J, Yu HL, Kaplan G, Weinstein DE. Autologous Schwann cells drive regeneration through a 6-cm autogenous venous nerve conduit. J Reconstr Microsurg 2001; 17 (8) 589-595 , discussion 596–597
• 20 Mohanna PN, Young RC, Wiberg M, Terenghi G. A composite poly-hydroxybutyrate-glial growth factor conduit for long nerve gap repairs. J Anat 2003; 203 (6) 553-565
• 21 Lee JY, Giusti G, Friedrich PF , et al. The effect of collagen nerve conduits filled with collagen-glycosaminoglycan matrix on peripheral motor nerve regeneration in a rat model. J Bone Joint Surg Am 2012; 94 (22) 2084-2091
• 22 de Ruiter GC, Malessy MJ, Yaszemski MJ, Windebank AJ, Spinner RJ. Designing ideal conduits for peripheral nerve repair. Neurosurg Focus 2009; 26 (2) E5
• 23 Midha R. Emerging techniques for nerve repair: nerve transfers and nerve guidance tubes. Clin Neurosurg 2006; 53: 185-190
• 24 Konofaos P, Ver Halen JP. Nerve repair by means of tubulization: past, present, future. J Reconstr Microsurg 2013; 29 (3) 149-164
• 25 Dai LG, Huang GS, Hsu SH. Sciatic nerve regeneration by co-cultured Schwann cells and stem cells on microporous nerve conduits. Cell Transplant 2012; (e-pub ahead of print)
• 26 Haug A, Bartels A, Kotas J, Kunesch E. Sensory recovery 1 year after bridging digital nerve defects with collagen tubes. J Hand Surg Am 2013; 38 (1) 90-97
• 27 Siemionow M, Bozkurt M, Zor F. Regeneration and repair of peripheral nerves with different biomaterials: review. Microsurgery 2010; 30 (7) 574-588
• 28 Schmalbruch H. Fiber composition of the rat sciatic nerve. Anat Rec 1986; 215 (1) 71-81