J Reconstr Microsurg 2014; 30(09): 607-616
DOI: 10.1055/s-0034-1372477
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nerve Regeneration: Is There an Alternative to Nervous Graft?

Rodrigo Guerra Sabongi
1   Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
,
Luiz Augusto Lucas Martins De Rizzo
2   Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
,
Marcela Fernandes
3   Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
,
Sandra Gomes Valente
3   Division of Hand Surgery, Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
,
João Baptista Gomes dos Santos
1   Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
,
Flávio Faloppa
1   Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
,
Vilnei Mattioli Leite
1   Department of Orthopedics and Traumatology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
› Author Affiliations
Further Information

Publication History

16 October 2013

26 January 2014

Publication Date:
04 August 2014 (online)

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Abstract

Background In nerve injury with nervous gap, no restitution method was found better than the autograft, however, it has the disadvantage of damaging a normal nerve to be used as a graft. Platelet-rich plasma (PRP) is a possible filler material for vein grafts used as conduits for nerve regeneration, preventing its collapse, and providing growth factors and osteoconductive proteins.

Methods Isogenic rats were randomly divided into three groups. They received nerve autografts (GRF), PRP-containing vein grafts or a sham operation. Outcomes were evaluated by the sciatic functional index (SFI), morphometric, and morphologic analyses of the nerve distal to the lesion, and the number of spinal cord motoneurons positive for retrograde Fluoro-Gold (Santa Cruz Biotechnology, Inc., Dallas, TX) tracer.

Results The PRP and GRF groups had lower SFI values than the control animals throughout the postoperative period. The SFI was significantly higher in the PRP group than the GRF group at 90 days postoperatively (p = 0.011). Fiber diameter and number of motoneurons were significantly decreased in both the PRP and GRF groups, as compared with the control.

Conclusion PRP within a vein conduit may be an effective alternative or adjuvant to GRF, the current preferred treatment for nerve injury with a nerve gap, and further investigations are required to fully define the role of PRP in nerve regeneration.