Experimental Methods to Simulate and Evaluate Postsurgical Peripheral Nerve Scarring

Crosio, Alessandro; Ronchi, Giulia; Fornasari, Benedetta Elena; Odella, Simona; Raimondo, Stefania; Tos, Pierluigi

doi:10.3390/jcm10081613

Cited by 8 publications

(5 citation statements)

References 81 publications

(36 reference statements)

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“…Although silicone is biocompatible, its non-biodegradability poses clinical use problems, potentially leading to increased fibrosis [31,34]. Today, silastic tube cuffing is even used as a scarring induction method in experimental models [11]. Contrarily, polylactide generally is well-biodegradable [79].…”

Section: Discussionmentioning

confidence: 99%

“…One example of this technique is shown in Figure 1, where a synthetic collagen matrix is being wrapped around a part of a rat's sciatic nerve. While the rat sciatic nerve model is the most popular animal model for peripheral nerve injury and scarring, various methods are described to induce peripheral nerve scarring and evaluate outcomes in an experimental setting [11]. A number of studies use transection and consecutive epineural sutures for scar induction, while some authors use less traumatic methods avoiding neurotmesis [11].…”

Section: Introductionmentioning

confidence: 99%

“…While the rat sciatic nerve model is the most popular animal model for peripheral nerve injury and scarring, various methods are described to induce peripheral nerve scarring and evaluate outcomes in an experimental setting [11]. A number of studies use transection and consecutive epineural sutures for scar induction, while some authors use less traumatic methods avoiding neurotmesis [11]. However, transection injuries are significantly more traumatic than other methods of scar induction, comparing materials tested with different injury types is hardly possible.…”

Section: Introductionmentioning

confidence: 99%

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Shielding the Nerve: A Systematic Review of Nerve Wrapping to Prevent Adhesions in the Rat Sciatic Nerve Model

Mayrhofer-Schmid,

Klemm,

Aman

et al. 2023

JPM

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Background: Peripheral nerve pathology is frequently encountered in clinical practice among peripheral nerve and extremity surgeons. One major factor limiting nerve regeneration and possibly leading to revision surgeries is the development of traumatic or postoperative adhesions and scarring around nerves. In experimental models, different materials have been studied to limit scar tissue formation when wrapped around nerves. Methods: A systematic review of studies describing nerve-wrapping materials in a non-transectional rat sciatic nerve model was performed following the PRISMA guidelines. Literature describing nerve-wrapping methods for the prevention of peripheral nerve scarring in rat sciatic nerve models was identified using PubMed and Web of Science, scanned for relevance and analyzed. Results: A total of 15 original articles describing 23 different materials or material combinations for nerve wrapping were included. The heterogeneity of the methods used did not allow a meta-analysis, thus, a systematic review was performed. Out of 28 intervention groups, 21 demonstrated a preventive effect on scar tissue formation in at least one qualitative or quantitative assessment method. Conclusions: The analyzed literature describes a variety of materials from different origins to limit peripheral nerve scarring and adhesions. Thus, a scar-preventive effect by wrapping peripheral nerves as adhesion prophylaxis seems likely. However, a quantitative comparison of the studies to identify the optimal material or technique is not possible with the diversity of used models and study designs. Therefore, further research needs to be performed to identify the optimal nerve wraps to be used routinely in clinical practice.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Shielding the Nerve: A Systematic Review of Nerve Wrapping to Prevent Adhesions in the Rat Sciatic Nerve Model

Mayrhofer-Schmid,

Klemm,

Aman

et al. 2023

JPM

View full text Add to dashboard Cite

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“…After spinal surgery, fibroblasts and other cells involved in wound healing can produce extracellular matrix proteins, leading to the formation of scar tissue [ 29 ]. This scar tissue can affect the local tissue environment and contribute to pain by compressing or tethering nerve roots [ 30 ]. It is essential to recognize that the molecular mechanisms contributing to PSPS-T1/2 can vary among individuals and may be influenced by factors such as the type of surgery, pre-existing medical conditions, and individual genetic differences.…”

Section: Molecular Mechanisms Underlying the Pathology Of The Psps-t1...mentioning

confidence: 99%

Failed Back Surgery Syndrome: No Longer a Surgeon’s Defeat—A Narrative Review

Miękisiak

2023

Medicina

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The introduction of the term Persistent Spinal Pain Syndrome (PSPS-T1/2), replacing the older term Failed Back Surgery Syndrome (FBSS), has significantly influenced our approach to diagnosing and treating post-surgical spinal pain. This comprehensive review discusses this change and its effects on patient care. Various diagnostic methods are employed to elucidate the underlying causes of back pain, and this information is critical in guiding treatment decisions. The management of PSPS-T1/2 involves both causative treatments, which directly address the root cause of pain, and symptomatic treatments, which focus on managing the symptoms of pain and improving overall function. The importance of a multidisciplinary and holistic approach is emphasized in the treatment of PSPS-T1/2. This approach is patient-centered and treatment plans are customized to individual patient needs and circumstances. The review concludes with a reflection on the impact of the new PSPS nomenclature on the perception and management of post-surgical spinal pain.

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“…Peripheral nerve injury may result in partial loss of sensory and motor functions, muscle atrophy, and in severe cases, poor limb function and complete paralysis, reducing the patient's quality of life and resulting in serious social and economic consequences (3,4). Peripheral nerve regeneration is affected by many factors such as perineural and intraneural scarring, surgical suture method, and age (5,6). Perineural and intraneural scarring at the repair site are important factors affecting axon regeneration, which reduce the growth rate of axons and limits the number of regrowing axons (7,8).…”

Section: Introductionmentioning

confidence: 99%

Electrospun Polycaprolactone (PCL)-Amnion Nanofibrous Membrane Promotes Nerve Regeneration and Prevents Fibrosis in a Rat Sciatic Nerve Transection Model

et al. 2022

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Functional recovery after peripheral nerve injury repair is typically unsatisfactory. An anastomotically poor microenvironment and scarring at the repair site are important factors impeding nerve regeneration. In this study, an electrospun poly-e-caprolactone (PCL)-amnion nanofibrous membrane comprising an amnion membrane and nonwoven electrospun PCL was used to wrap the sciatic nerve repair site in the rat model of a sciatic nerve transection. The effect of the PCL-amnion nanofibrous membrane on improving nerve regeneration and preventing scarring at the repair site was evaluated by expression of the inflammatory cytokine, sciatic functional index (SFI), electrophysiology, and histological analyses. Four weeks after repair, the degree of nerve adhesion, collagen deposition, and intraneural macrophage invasion of the PCL-amnion nanofibrous membrane group were significantly decreased compared with those of the Control group. Moreover, the PCL-amnion nanofibrous membrane decreased the expression of pro-inflammatory cytokines such as interleukin(IL)-6, Tumor Necrosis Factor(TNF)-a and the number of pro-inflammatory M1 macrophages, and increased the expression of anti-inflammatory cytokine such as IL-10, IL-13 and anti-inflammatory M2 macrophages. At 16 weeks, the PCL-amnion nanofibrous membrane improved functional recovery, including promoting nerve Schwann cell proliferation, axon regeneration, and reducing the time of muscle denervation. In summary, the PCL-amnion nanofibrous membrane effectively improved nerve regeneration and prevent fibrosis after nerve repair, which has good clinical application prospect for tissue repair.

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Experimental Methods to Simulate and Evaluate Postsurgical Peripheral Nerve Scarring

Cited by 8 publications

References 81 publications

Shielding the Nerve: A Systematic Review of Nerve Wrapping to Prevent Adhesions in the Rat Sciatic Nerve Model

Shielding the Nerve: A Systematic Review of Nerve Wrapping to Prevent Adhesions in the Rat Sciatic Nerve Model

Failed Back Surgery Syndrome: No Longer a Surgeon’s Defeat—A Narrative Review

Electrospun Polycaprolactone (PCL)-Amnion Nanofibrous Membrane Promotes Nerve Regeneration and Prevents Fibrosis in a Rat Sciatic Nerve Transection Model

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