Abstract
Introduction
In severe nerve lesion, nerve defects and in brachial plexus reconstruction, autologous nerve grafting is the golden standard. Although, nerve grafting technique is the best available approach a major disadvantages exists: there is a limited source of autologous nerve grafts.
This study presents data on the use of tubular scaffolds with uniaxial pore orientation from experimental biodegradable polyurethanes coated with fibrin sealant to regenerate a 8 mm resected segment of rat sciatic nerve.
Methods
Tubular scaffolds: prepared by extrusion of the polymer solution in DMF into water coagulation bath. The polymer used for the preparation of tubular scaffolds was a biodegradable polyurethane based on hexamethylene diisocyanate, poly(ε-caprolactone) and dianhydro-D-sorbitol.
Experimental model
Eighteen Sprague Dawley rats underwent midthigh sciatic nerve transection and were randomly assigned to two experimental groups with immediate repair: (1) tubular scaffold, (2) 180° rotated sciatic nerve segment (control). Serial functional measurements (toe spread test, placing tests) were performed weekly from 3rd to 12th week after nerve repair. On week 12, electrophysiological assessment was performed. Sciatic nerve and scaffold/nerve grafts were harvested for histomorphometric analysis. Collagenic connective tissue, Schwann cells and axons were evaluated in the proximal nerve stump, the scaf-fold/nerve graft and the distal nerve stump.
The implants have uniaxially-oriented pore structure with a pore size in the range of 2 μm (the pore wall) and 75 × 700 μm (elongated pores in the implant lumen). The skin of the tubular implants was nonporous.
Animals which underwent repair with tubular scaffolds of biodegradable polyurethanes coated with diluted fibrin sealant had no significant functional differences compared with the nerve graft group.
Control group resulted in a trend-wise better electrophysiological recovery but did not show statistically significant differences.
There was a higher level of collagenic connective tissue within the scaffold and within the distal nerve stump. Schwann cells migrated into the polyurethane scaffold. There was no statistical difference to the nerve graft group although Schwann cell counts were lower especially within the middle of the polyurethane scaffold. Axon counts showed a trend-wise decrease within the scaffold.
Conclusion
These results suggest that biodegradable polyurethane tubular scaffolds coated with diluted fibrin sealant support peripheral nerve regeneration in a standard gap model in the rat up to 3 months. Three months after surgery no sign of degradation could be seen.
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© 2007 Springer-Verlag
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Hausner, T. et al. (2007). Nerve regeneration using tubular scaffolds from biodegradable Polyurethane. In: Millesi, H., Schmidhammer, R. (eds) How to Improve the Results of Peripheral Nerve Surgery. Acta Neurochirurgica Supplementum, vol 100. Springer, Vienna. https://doi.org/10.1007/978-3-211-72958-8_15
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DOI: https://doi.org/10.1007/978-3-211-72958-8_15
Publisher Name: Springer, Vienna
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