Vascularized versus Nonvascularized Nerve Grafts: An Experimental Structural Comparison

Seckel, Brooke R.; Ryan, Sheila E.; Simons, Joshua E.; Gagne, Roland G.; Watkins, Elton

doi:10.1097/00006534-198608000-00012

Cited by 63 publications

(18 citation statements)

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“…Our results of somatosensory recovery reflect comparable findings. Another finding was described by Seckel et al 16 who found no improvement in histomorphometric analysis in rat sciatic nerves repaired with vascularized grafts. The explanation of differences in these results remains unclear and needs further investigation.…”

Section: Discussionmentioning

confidence: 74%

The epineural sleeve technique for nerve graft reconstruction enhances nerve recovery

Lubiatowski¹,

Ünsal²,

Nair³

et al. 2008

Microsurgery

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The purpose of the study was evaluation of nerve recovery following epineural sleeve technique for graft reconstruction in rat sciatic nerve. This technique provides the epineural sleeve to cover and separate the site of coaptation. Animals were divided into three groups: CNG-conventional nerve grafting, ESN-epineural sleeve from recipient nerve stumps, ESG-epineural sleeve from graft. Nerve regeneration was evaluated by pin-prick, toe-spread test, walking track analysis and somatosensory-evoked potentials (SEP), gastrocnemius index (GI), and histomorphometric evaluation. Most parameters (SFI, SEPs, and GI) showed significantly better nerve recovery for ESN group when compared to conventional CNG group. Also ESG group revealed better result for SFI. Better functional results for ESN and ESG groups were further confirmed by histomorphometric analysis: higher axon density and diameters as well as thicker myelin sheath. Epineural sleeve graft technique may be promising method with potential application for nerve reconstructive procedures. Better functional nerve recovery can be anticipated.

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Section: Discussionmentioning

confidence: 74%

The epineural sleeve technique for nerve graft reconstruction enhances nerve recovery

Lubiatowski¹,

Ünsal²,

Nair³

et al. 2008

Microsurgery

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“…This finding, most prominent at the proximal and distal graft coaptation sites but not the graft center 15 days after surgery, may have also been related to scar tissue in response to suture material and surgical microtrauma. Nerve grafts are affected by both an intrinsic blood supply originating from the vaso nervorum of the host nerve that preferentially revascularizes the graft edges as seen at the 15 day timepoint, as well as an extrinsic blood supply providing a more uniform distribution of blood supply to the entire graft ,Breidenbach and Terzis, 1986,Hobson, 2002,Lundborg, 1988,Ozcan, et al, 1991,Seckel, et al, 1986,Terzis, et al, 1995. A modest inflammatory reaction related to surgical repair and the presence of suture material at both the proximal and distal coaptations also contributes to increased vascularity.…”

Section: Discussionmentioning

confidence: 99%

A double-transgenic mouse used to track migrating Schwann cells and regenerating axons following engraftment of injured nerves

Hayashi

Koob

Liu

et al. 2007

Experimental Neurology

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We propose that double-transgenic thy1-CFP(23)/S100-GFP mice whose Schwann cells constitutively express green fluorescent protein (GFP) and axons express cyan fluorescent protein (CFP) can be used to serially evaluate the temporal relationship between nerve regeneration and Schwann cell migration through acellular nerve grafts. Thy1-CFP(23)/S100-GFP and S100-GFP mice received non-fluorescing cold preserved nerve allografts from immunologically disparate donors. In vivo fluorescent imaging of these grafts was then performed at multiple points. The transected sciatic nerve was reconstructed with a 1-cm nerve allograft harvested from a Balb-C mouse and acellularized via 7 weeks of cold preservation prior to transplantation. The presence of regenerated axons and migrating Schwann cells was confirmed with confocal and electron microscopy on fixed tissue. Schwann cells migrated into the acellular graft (163+/-15 intensity units) from both proximal and distal stumps, and bridged the whole graft within 10 days (388+/-107 intensity units in the central 4-6 mm segment). Nerve regeneration lagged behind Schwann cell migration with 5 or 6 axons imaged traversing the proximal 4 mm of the graft under confocal microcopy within 10 days, and up to 21 labeled axons crossing the distal coaptation site by 15 days. Corroborative electron and light microscopy 5 mm into the graft demonstrated relatively narrow diameter myelinated (431+/-31) and unmyelinated (64+/-9) axons by 28 but not 10 days. Live imaging of the double-transgenic thy1-CFP(23)/S100-GFP murine line enabled serial assessment of Schwann cell-axonal relationships in traumatic nerve injuries reconstructed with acellular nerve allografts.

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“…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.…”

Section: Vascular Supply Of the Recipient Bedmentioning

confidence: 99%

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

Terzis

Kostopoulos

2009

Plastic and Reconstructive Surgery

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Vascularized versus Nonvascularized Nerve Grafts: An Experimental Structural Comparison

Cited by 63 publications

References 0 publications

The epineural sleeve technique for nerve graft reconstruction enhances nerve recovery

The epineural sleeve technique for nerve graft reconstruction enhances nerve recovery

A double-transgenic mouse used to track migrating Schwann cells and regenerating axons following engraftment of injured nerves

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

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