Is Early Vascularization of Nerve Grafts Necessary?

Abstract

Revascularization and regeneration through vascularized and non-vascularized nerve grafts were compared on optimal and adverse graft beds in 76 rabbit sciatic nerves. A delay in revascularization of more than 14 days was found to occur in 30 mm long, non-vascularized nerve grafts placed on completely avascular graft graft beds. However, over a period of 44 weeks, this prolonged ischaemia did not adversely affect nerve regeneration. The vascularized nerve grafts did not differ significantly with respect to the rate of regeneration, motor conduction velocity, fibre diameter and thickness of myelin sheath. In rabbits, the provision of early vascularity does not appear to confer superior regeneration through nerve grafts. The clinical use of vascularized nerve grafts is discussed in the light of these results.

Expression of α, β, and γ Catenins in Vascularized and Nonvascularized Nerve Grafts During the Regeneration Process

“…Many authors have demonstrated various similarities and differences between vascularized and nonvascularized grafts. [22][23][24][25][26][27] The most recognizable might be that the number of regenerating axons and the regeneration velocity do not differ between the two methods, even when the graft was placed into avascular tissue. 25 Our previous results on the different expression of E and N cadherins between the two methods failed to explain these identical findings regarding axonal regeneration.…”

Vascularized Ulnar Nerve Graft: 151 Reconstructions for Posttraumatic Brachial Plexus Palsy

“…30,31 However, Mani et al did not find any significant difference between vascularized and nonvascularized nerve grafts in avascular graft beds, even after prolonged initial period of revascularization for nonvascularized nerve grafts. 32 Normal recipient bed experimental studies are conflicted as to which produces the best results: Restrepo et al, 33 Shibata et al, 34 Kanaya et al, 35 and Schultes et al 36 reported better results with vascularized nerve grafts, whereas McCullough et al, 37 Pho et al, 38 and Seckel et al 39 did not find any difference.…”

Vascularization Strategies for Peripheral Nerve Tissue Engineering

“…In a nonvascularized nerve graft (NVNG), neovascularization, the onset of new blood vessel formation at the interface with host tissue, usually occurs by the third day after surgery under supportive conditions (Mani et al, ). Conversely, neovascularization in VNGs can occur before the onset of ischemia, due to the presence of vascular structures within the graft (Mani et al, ).…”

“…In a nonvascularized nerve graft (NVNG), neovascularization, the onset of new blood vessel formation at the interface with host tissue, usually occurs by the third day after surgery under supportive conditions (Mani et al, ). Conversely, neovascularization in VNGs can occur before the onset of ischemia, due to the presence of vascular structures within the graft (Mani et al, ). As a result, VNGs are considered to be superior to NVNGs and have been successfully used in several clinical cases (Shibata et al, , Rose and Kowalski, , Restrepo et al, , Koshima and Harii, ).…”