Epineurial sheath tube (EST) technique: an experimental peripheral nerve repair model

Bozkurt, Ahmet; Dunda, Sebastian E.; Dm, Dan O'Dey; Brook, Gary; Suschek, Christoph V.; Pallua, Norbert

doi:10.1179/1743132811y.0000000029

Cited by 16 publications

(10 citation statements)

References 14 publications

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Section: Introductionsupporting

confidence: 61%

“…In line with our previous studies, cell compatibility between PM, providing a microstructured longitudinal orientated inner framework, and OEC was already shown (Bozkurt et al, ). Therefore, PM was seeded with OEC, and the cell‐loaded scaffolds were implanted into a 20‐mm sciatic nerve gap according to the epineural sheath tube technique (also described earlier in Bozkurt, Dunda, et al, ). Peripheral nerve regeneration was evaluated 12 weeks after implantation by histomorphometric analysis, retrograde tracing, and functionally, through measuring the toe spreading (TS;i.e., Visual static sciatic index (SSI)).…”

Section: Introductionmentioning

confidence: 99%

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Cell-enrichment with olfactory ensheathing cells has limited local extra beneficial effects on nerve regeneration supported by the nerve guide Perimaix

Bozkurt

Kim

Altinova

et al. 2018

J Tissue Eng Regen Med

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The reconstruction of peripheral nerve injuries is clinically challenging, and today, the autologous nerve transplantation is still considered as the only gold standard remedy for nerve lesions where a direct nerve coaptation is not possible. Nevertheless, the functional merits of many biomaterials have been tested as potential substitutes for the autologous nerve transplant. One of the strategies that have been pursued is the combination of bioengineered nerve guides with cellular enrichment. In this present study, we combined the previously evaluated collagen-based and microstructured nerve guide Perimaix with olfactory ensheathing cell enrichment. Rat sciatic nerve defects of 20 mm were either bridged by a cell-seeded or nonseeded nerve guide or an autologous nerve transplant. Animals were monitored for 12 weeks for structural and functional parameters. Seeded cells survived on Perimaix, and following implantation aligned along the microstructured Perimaix framework. Axonal densities within the cell-seeded nerve guides were higher than in the nonseeded nerve guides and were comparable to the autograft. Additionally, cell-seeding had local beneficial effects on myelination within the nerve guide, as myelin sheath thickness was enhanced when compared with the empty scaffold. Nevertheless, for bridging the nerve gap of 20 mm, both the cell-seeded as well as nonseeded scaffolds were equally efficient regarding the functional outcome, which did not differ between the autograft, seeded or nonseeded groups. Our data demonstrate that olfactory ensheathing cell enrichment has local effects on nerve regeneration in combination with the Perimaix nerve guide. Surprisingly, for traversing the lesion gap, additional cell-seeding is not crucial.

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Section: Introductionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

Cell-enrichment with olfactory ensheathing cells has limited local extra beneficial effects on nerve regeneration supported by the nerve guide Perimaix

Bozkurt

Kim

Altinova

et al. 2018

J Tissue Eng Regen Med

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“…For chitosan core implantation (CES), the epifascicular epi-/perineurium was cut in a longitudinal direction and the fascicles were resected over a distance of 10 mm leaving an empty epineural sleeve [25, 26]. The chitosan core was then implanted and the epifascicular epi-/perineurium was closed using single interrupted 9-0 Ethilon sutures.…”

Section: Methodsmentioning

confidence: 99%

Outer Electrospun Polycaprolactone Shell Induces Massive Foreign Body Reaction and Impairs Axonal Regeneration through 3D Multichannel Chitosan Nerve Guides

Duda

Dreyer

Behrens

et al. 2014

BioMed Research International

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We report on the performance of composite nerve grafts with an inner 3D multichannel porous chitosan core and an outer electrospun polycaprolactone shell. The inner chitosan core provided multiple guidance channels for regrowing axons. To analyze the in vivo properties of the bare chitosan cores, we separately implanted them into an epineural sheath. The effects of both graft types on structural and functional regeneration across a 10 mm rat sciatic nerve gap were compared to autologous nerve transplantation (ANT). The mechanical biomaterial properties and the immunological impact of the grafts were assessed with histological techniques before and after transplantation in vivo. Furthermore during a 13-week examination period functional tests and electrophysiological recordings were performed and supplemented by nerve morphometry. The sheathing of the chitosan core with a polycaprolactone shell induced massive foreign body reaction and impairment of nerve regeneration. Although the isolated novel chitosan core did allow regeneration of axons in a similar size distribution as the ANT, the ANT was superior in terms of functional regeneration. We conclude that an outer polycaprolactone shell should not be used for the purpose of bioartificial nerve grafting, while 3D multichannel porous chitosan cores could be candidate scaffolds for structured nerve grafts.

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“…Several scholars have used the epineurial sheath as a conduit to span nerve gaps. [11][12][13] Methods for using the orthotopic epineurial sheath by sliding it onto the nerve repair site 14 or using the turnover epineurial sheath tube 15 have been described previously with promising results. However, stripping the epineurium damages axons and decreases blood perfusion at the repair site.…”

mentioning

confidence: 99%

Use of Small Gap Anastomosis for the Repair of Peripheral Nerve Injury by Cutting and Sleeve Jointing the Epineurium

Wang

Zhao

Jiang

et al. 2015

J reconstr Microsurg

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Epineurial sheath tube (EST) technique: an experimental peripheral nerve repair model

Cited by 16 publications

References 14 publications

Cell-enrichment with olfactory ensheathing cells has limited local extra beneficial effects on nerve regeneration supported by the nerve guide Perimaix

Cell-enrichment with olfactory ensheathing cells has limited local extra beneficial effects on nerve regeneration supported by the nerve guide Perimaix

Outer Electrospun Polycaprolactone Shell Induces Massive Foreign Body Reaction and Impairs Axonal Regeneration through 3D Multichannel Chitosan Nerve Guides

Use of Small Gap Anastomosis for the Repair of Peripheral Nerve Injury by Cutting and Sleeve Jointing the Epineurium

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