Doxorubicin for prevention of epineurial fibrosis in a rat sciatic nerve model: outcome based on gross postsurgical, histopathological, and ultrastructural findings

Albayrak, Baki S.; İsmailoğlu, Özgür; İlbay, Konuralp; Yaka, Umut; Tanrıöver, Gamze; Görgülü, Adnan; Demır, Necdet

doi:10.3171/2009.9.spine09407

Cited by 19 publications

(21 citation statements)

References 32 publications

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“…Postoperative perineural scarring and adhesion are inevitable, even when using meticulous surgical techniques, including microsurgical techniques. Several pharmacologic agents reduce scar formation in peripheral nerve surgery, including cis-hydroxyproline,22) anti-transforming growth factor-β1 antibody,23) citicoline,24) ADCON-T/N,16) and doxorubicin 25). All these drugs may have positive effects in experimental studies, but they have not yet been applied clinically.…”

Section: Discussionmentioning

confidence: 99%

Effect of Hyaluronic Acid-Carboxymethylcellulose Solution on Perineural Scar Formation after Sciatic Nerve Repair in Rats

et al. 2011

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BackgroundScar tissue formation is the major cause of failure in peripheral nerve surgery. Use of a hyaluronic acid-carboxymethylcellulose (HA-CMC) membrane (Seprafilm) as a solid anti-adhesion barrier agent is one of the therapeutic approaches to reduce postoperative scar tissue formation. However, a solid membrane may not be suitable for repair of a weak peripheral nerve site. This study examined the effect of HA-CMC solution on perineural scar formation after peripheral nerve repair in rats.MethodsThe sciatic nerves of 40 rats were transected and then immediately repaired using 10-0 nylon. The nerves were divided randomly into two groups. Saline and HA-CMC solution were applied topically to the nerve repair sites in the control and experimental groups, respectively. Reoperation was performed at 3, 6, 9, and 12 weeks to assess scar tissue formation. The assessment included the quality of wound healing, presence of perinueral adhesion, cellular components of the scar tissue, thickness of the scar tissue and histomorphological organization of the repair site.ResultsTopical application of the HA-CMC solution significantly decreased the macroscopic nerve adherence score and the numbers of the cellular components such as fibroblasts and inflammatory cells (p < 0.05, Mann-Whitney U-test). The scar tissue formation index was significantly lower in the experimental group at 12 weeks than that in the control group (p < 0.05, Mann-Whitney U-test). The grading scores of the histomorphological axonal organization at the repair site were significantly higher in the experimental group than those in the control group at 12 weeks (p < 0.05, Mann-Whitney U-test). No evidence of wound dehiscence or inflammatory reactions against the HA-CMC solution was noted.ConclusionsTopical application of a HA-CMC solution is effective in reducing the perineural scar formation and adhesion after sciatic nerve repair in rats, and is effective in promoting peripheral nerve regeneration at the repair site.

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Section: Discussionmentioning

confidence: 99%

Effect of Hyaluronic Acid-Carboxymethylcellulose Solution on Perineural Scar Formation after Sciatic Nerve Repair in Rats

et al. 2011

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“…Electrophysiological and histopathological results were consistent and parallel in both groups. The results were summarized in Table III. dISCuSSIon Peripheral nerve trauma, with an estimated incidence of 1/1000 in population per year, remains a major cause of morbidity and social disruption (4 (2,6,7,8,23,24,25,26,37). To the best of our knowledge no study has been reported on preventing intraneural scarring by radiation.…”

Section: Latency Measurementsmentioning

confidence: 92%

The effects of low-dose radiation in the treatment of sciatic nerve injury in rats

Göçmen¹,

Şirin²,

Oysul³

et al. 2011

Turkish Neurosurgery

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AIm: Peripheral nerve regeneration is often blocked by scar formation and misdirection of axon sprouts. The aim of this study is to evaluate electrophysiological and histopathological effects of low-dose radiation therapy on the prevention of intraneural scar formation in peripheral nerve injury. mAterIAl and methOds: In this experimental study, twenty rats were randomly divided into two groups. Left sciatic nerves were exposed and clipped by temporary aneurysm clip for 5 minutes in both groups. In all animals, electrophysiological recordings were performed between 22-24 hours after sciatic nerve injury. The control group was not given any treatment. In the experimental group, 700 cGy low-dose radiation was administered on the left sciatic nerves 24 hours after clipping. Six weeks after injury, electrophysiological recordings were performed in both groups and animals were sacrificed to evaluate the injured nerves histopathologically. results:We observed that low-dose radiotherapy increased the amplitude and improved latency measurements in electrophysiological examinations. Histopathologically, more axonal degeneration and vacuolization was observed in the control group comparing with the experimental group. Endoneural space increased slightly more in the control group than the experimental group.COnClusIOn: It was observed that low-dose radiotherapy may prevent intraneural scar formation and may improve electrophysiological recovery in sciatic nerve injury performed in rats.

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“…Improvements in our understanding of biocompatibility during device manufacture along with continuing improvement in surgical techniques has dramatically reduced the prevalence of significant immune-mediated peripheral nerve damage consequent to implantation of cuff electrodes [22]. Current efforts are directed at further reducing the inflammatory response in hopes of minimizing the possibility of electrical damage secondary to increased current required to stimulate nerve fibers through additional fibrous tissue [23,24].…”

Section: Inflammatory Nerve Injurymentioning

confidence: 99%

Histopathology of the stimulated Vagus nerve: primum non nocere

Cohen

Georgievskaya

2010

Heart Fail Rev

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A primary concern in the utilization of implantable neural interfaces for the treatment of medical diseases is to follow the Hippocratic dictum: First, do no harm. If we are to avoid harm to the Vagus nerve in our use of stimulatory electrodes in the treatment of heart failure, we must understand the structural and functional elements that comprise peripheral nerves, their susceptibility to various types of injury that might be expected to occur secondary to functional electrical stimulation and how to separate the various components of the response of peripheral nervous system elements to stresses that may occur in the complex interactions that take place between electrode and nerve. To this end, we review the functional histology of peripheral nerve, followed by a consideration of salient types of nerve injuries, which have been elucidated through the combination of careful observations of human disease and well-constructed experimental models. We then examine the extant literature on stimulation-induced nerve injury in light of recent developments in the understanding of electropermeabilization of biological membranes. Finally, we briefly discuss our experience using the CardioFit™ electrode on the canine Vagus nerve.

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Doxorubicin for prevention of epineurial fibrosis in a rat sciatic nerve model: outcome based on gross postsurgical, histopathological, and ultrastructural findings

Cited by 19 publications

References 32 publications

Effect of Hyaluronic Acid-Carboxymethylcellulose Solution on Perineural Scar Formation after Sciatic Nerve Repair in Rats

Effect of Hyaluronic Acid-Carboxymethylcellulose Solution on Perineural Scar Formation after Sciatic Nerve Repair in Rats

The effects of low-dose radiation in the treatment of sciatic nerve injury in rats

Histopathology of the stimulated Vagus nerve: primum non nocere

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