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Application of epineural sheath conduit for restoration of 6‐cm long nerve defects in a sheep median nerve model
Author(s) -
Siemionow Maria,
Cwykiel Joanna,
Uygur Safak,
Kwiecien Grzegorz,
Oztürk Can,
Szopinski Jacek,
Madajka Maria
Publication year - 2019
Publication title -
microsurgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.031
H-Index - 63
eISSN - 1098-2752
pISSN - 0738-1085
DOI - 10.1002/micr.30393
Subject(s) - medicine , epineurial repair , somatosensory evoked potential , nerve conduction velocity , cd31 , gap 43 protein , median nerve , anatomy , regeneration (biology) , glial fibrillary acidic protein , surgery , sciatic nerve , anesthesia , immunohistochemistry , pathology , biology , microbiology and biotechnology
Background Due to limited number of studies, we tested feasibility of autologous epineural sheath conduit (ESC) in repair of 6‐cm median nerve gaps in a sheep—the large animal model. Materials and methods Eight ewes, 6–8 months old, 30–35 kg, were divided into three experimental groups: group 1—no defect repair ( n = 4 nerves/group), group 2—autograft controls ( n = 6 nerves/group), group 3—autologous ESC filled with saline ( n = 6 nerves/group). ESC was constructed from a 6‐cm long segment of sheep median nerve and tested for expression of laminin B, Glial fibrillary acidic protein (GFAP), S‐100 and CD31 using immunofluorescent staining. At 6 months after nerve repair, nerve conduction velocity and somatosensory evoked potentials (SSEP) assessed neurosensory recovery, while histomorphometry tested nerve regeneration. Results Ex vivo characterization of ESC, before in vivo nerve gap repair, showed high laminin B expression, which supports axonal growth. At 6 months post‐repair, structural integrity of ESC was preserved. ESC was well‐vascularized and tissue adhesions were comparable to autograft controls. The maximal conduction velocities (29.80 ± 5.85 ms vs. 32.28 ± 6.75 ms; p = .44), action potential amplitudes (32.68 ± 17.44 mV vs. 44.14 ± 23.10 mV; p = .38) and SSEP amplitude values (6.18 ± 5.84 mV vs. 4.68 ± 2.53 mV; p = .28) were comparable between autograft and ESC groups. Presence of regenerating axons was confirmed in the distal segment of ESC at 6 months after repair. Conclusion The feasibility of ESC in restoration of 6‐cm long nerve defects in a sheep median nerve model was confirmed by nerve conduction assessments and correlated with axonal regeneration tested by histomorphometry. We confirmed ESC potential in support of regeneration of long nerve defects.