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The role of a barrier between two nerve fascicles in adjacency after transection and repair of a peripheral nerve trunk
Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of surgery.
2004 (English)In: Neurological Research, ISSN 0161-6412, Vol. 26, no 4, 363-370 p.Article in journal (Refereed) Published
Abstract [en]

Aberrant reinnervation of target organs caused by misdirected axonal growth at the repair site is a major reason for the poor functional outcome usually seen after peripheral nerve transection and repair. The following two studies investigate whether criss-crossing of regenerating rat sciatic nerve axons between tibial and peroneal nerve fascicles can be reduced by using a barrier at the coaption site. The left sciatic nerve was transected and repaired at mid-thigh as follows: epineural sutures (group A, A-II), fascicular repair of tibial and peroneal nerve fascicles (group B, B-II), fascicular repair of tibial and peroneal nerve fascicles separating the two fascicles with a pedicled fat flap (group C), Integra® (group D) or non-vascularized autologous fascia (group C-II). In the control groups E and D-II, only the left tibial fascicle was transected and repaired. Four and 5 months postoperatively, the outcome of regeneration was evaluated by histology, by retrograde tracing, and by assessment of the muscle force of the gastrocnemius and tibial anterior muscles. The tracing experiments showed that specificity of muscle reinnervation significantly improved when a barrier was employed, which significantly or clearly improved muscle twitch tension in groups C and D. However, muscle contraction force was not better when fascia was used as barrier. The histological picture indicated that this inferior result in group C-II was due to nerve compression caused by fibrotic scar tissue at the site of the fascia graft. Results of this study show that a pedicle fat flap and Integra® used as barrier significantly prevent aberrant reinnervation between two sutured nerve fascicles in adjacency resulting in improved motor recovery in rats. Non-vascularized autologous fascia however, reduces also criss-crossing of regenerating axons between the fascicles, but causes significant nerve compression.

Place, publisher, year, edition, pages
2004. Vol. 26, no 4, 363-370 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-24406DOI: 10.1179/016164104225013725Local ID: 6504OAI: diva2:244724
Available from: 2009-10-07 Created: 2009-10-07 Last updated: 2011-01-12

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Lutz, Barbara
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