Protocol of a Nerve Neurotmesis Sciatic Repair using Polyvinyl Alcohol Biofilm in Wistar Rats

 

 Permissions and Reprints

Abstract

Background Animal models are commonly used to assess the efficacy of new materials to be employed in the surgical repair of a nerve injury. However, there is no published surgical repair protocol for sciatic nerve neurotmesis in rats.

Objective To produce and evaluate a protocol for the tubing technique using a polyvinyl alcohol biofilm after sciatic nerve neurotmesis.

Methods Eighteen rats were randomized into 3 groups (n = 6 per group): control group - CG, neurotmesis group - NG, and neurotmesis biofilm group - NBG. The NG and NBG animals were submitted to neurotmesis of the sciatic nerve at 60 days of life, followed by suture of the nerve stumps; in the NBG, the animals had the suture involved by polyvinyl alcohol biofilm. A descriptive evaluation of the surgical technique was performed after the experimental period. The Shapiro-Wilk normality test was used for body weight, and analysis of variance (ANOVA) with Bonferroni posthoc (p < 0.05) was applied.

Results All groups showed good repair of the skin and muscle sutures; however, 33.30% of the CG presented disruption of skin points. Furthermore, 16.70% of the stumps were not structurally aligned and 33.30% had neuromas in the NG, while in the NBG, all stumps were aligned and none of them had neuroma .

Conclusions The present study was able to produce a protocol with high reproducibility in view of the mechanical stability, targeting of the nerve stumps, muscle healing, the low frequency of skin breakage and the low complexity level of the technique, and it can be used in future studies that aim to evaluate other biomaterials for nerve repair in rats.

Resumo

Introdução Modelos animais são comumente utilizados para avaliar a eficácia de novos materiais a ser empregados no reparo cirúrgico de lesões nervosas. No entanto, não há protocolo de reparo cirúrgico publicado para neurotmese do nervo ciático em ratos.

Objetivo Produzir e avaliar um protocolo para a técnica de tubulização usando um biofilme de álcool polivinílico após uma neurotmese do nervo ciático.

Métodos Dezoito ratos foram randomizados em três grupos (n = 6 por grupo): grupo controle - GC, grupo neurotmese - GN e grupo neurotmese biofilme - GNB. Os animais do GN e do GNB foram submetidos à neurotmese do nervo ciático aos 60 dias de vida, seguida de sutura dos cotos do nervo; no GNB, os animais tiveram a sutura envolvida por biofilme de álcool polivinílico. Após o período experimental, foi realizada avaliação descritiva da técnica cirúrgica. Para o peso corporal, foi utilizado o teste de normalidade Shapiro-Wilk e aplicada a análise de variância (ANOVA) com posthoc de Bonferroni (p < 0,05).

Resultados Todos os grupos apresentaram bom reparo de suturas de pele e musculares; porém, 33,30% do GC apresentou rompimento dos pontos da pele. Além disso, 16,70% dos cotos não estavam estruturalmente alinhados e 33,30% apresentavam neuromas no GN, enquanto todos os cotos estavam alinhados e nenhum apresentava neuroma no GNB.

Conclusões O presente estudo foi capaz de produzir um protocolo com alta reprodutibilidade tendo em vista a estabilidade mecânica, direcionamento dos cotos nervosos, cicatrização muscular, a baixa frequência de rompimento da pele e o baixo nível de complexidade da técnica, podendo ser utilizado em estudos futuros que avaliem outros biomateriais para reparo de nervo em ratos.

Ethical Declaration

The procedures used for handling and caring for animals are in accordance with international standards established by the National Institute of Health Guide for Care and Use of Animal, and the project was approved by the Ethics Committee on the Use of Laboratory Animals (CEUA, in the Portuguese acronym) of the Biological Sciences Center - Universidade Federal de Pernambuco under protocol number 23076.052306/2017–10.

Publication History

Received: 27 May 2021

Accepted: 13 October 2021

Article published online:
18 October 2023

© 2023. Sociedade Brasileira de Neurocirurgia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil

• References

• 1 Brunelli GA, Battiston B, Vigasio A, Brunelli G, Marocolo D. Bridging nerve defects with combined skeletal muscle and vein conduits. Microsurgery 1993; 14 (04) 247-251
  CrossrefPubMedGoogle Scholar
• 2 Adams AM, VanDusen KW, Kostrominova TY, Mertens JP, Larkin LM. Scaffoldless tissue-engineered nerve conduit promotes peripheral nerve regeneration and functional recovery after tibial nerve injury in rats. Neural Regen Res 2017; 12 (09) 1529-1537
  CrossrefPubMedGoogle Scholar
• 3 Konofaos P, Ver Halen JP. Nerve repair by means of tubulization: past, present, future. J Reconstr Microsurg 2013; 29 (03) 149-164
  Article in Thieme ConnectPubMedGoogle Scholar
• 4 Moskow J, Ferrigno B, Mistry N. et al. Review: Bioengineering approach for the repair and regeneration of peripheral nerve. Bioact Mater 2018; 4 (01) 107-113
  PubMedGoogle Scholar
• 5 Zhang PX, Han N, Kou YH. et al. Tissue engineering for the repair of peripheral nerve injury. Neural Regen Res 2019; 14 (01) 51-58
  CrossrefPubMedGoogle Scholar
• 6 Houshyar S, Bhattacharyya A, Shanks R. Peripheral Nerve Conduit: Materials and Structures. ACS Chem Neurosci 2019; 10 (08) 3349-3365
  CrossrefPubMedGoogle Scholar
• 7 Chen Y. Ed. Chitosan composites nerve conduits. E3S Web of Conferences; 2019: EDP Sciences.
  PubMedGoogle Scholar
• 8 Ronchi G, Nicolino S, Raimondo S. et al. Functional and morphological assessment of a standardized crush injury of the rat median nerve. J Neurosci Methods 2009; 179 (01) 51-57
  CrossrefPubMedGoogle Scholar
• 9 Braga Silva J, Marchese GM, Cauduro CG, Debiasi M. Nerve conduits for treating peripheral nerve injuries: A systematic literature review. Hand Surg Rehabil 2017; 36 (02) 71-85
  CrossrefPubMedGoogle Scholar
• 10 Asato F, Butler M, Blomberg H, Gordh T. Variation in rat sciatic nerve anatomy: implications for a rat model of neuropathic pain. J Peripher Nerv Syst 2000; 5 (01) 19-21
  CrossrefPubMedGoogle Scholar
• 11 Arslantunali D, Dursun T, Yucel D, Hasirci N, Hasirci V. Peripheral nerve conduits: technology update. Med Devices (Auckl) 2014; 7: 405-424
  PubMedGoogle Scholar
• 12 Weller WJ. Emerging Technologies in Upper Extremity Surgery: Polyvinyl Alcohol Hydrogel Implant for Thumb Carpometacarpal Arthroplasty and Processed Nerve Allograft and Nerve Conduit for Digital Nerve Repairs. Orthop Clin North Am 2019; 50 (01) 87-93
  CrossrefPubMedGoogle Scholar
• 13 Wu R, Wang L, Chen F. et al. Evaluation of artificial nerve conduit and autografts in peripheral nerve repair in the rat model of sciatic nerve injury. Neurol Res 2016; 38 (05) 461-466
  CrossrefPubMedGoogle Scholar
• 14 Mohammadi R, Amini K, Charehsaz S. Homeopathic treatment for peripheral nerve regeneration: an experimental study in a rat sciatic nerve transection model. Homeopathy 2012; 101 (03) 141-146
  Article in Thieme ConnectPubMedGoogle Scholar
• 15 Prado RR, Mendonça EP, Monteiro GP, de Melo RT, Nalevaiko PC, Rossi DAJP. Apostila ilustrada de cirurgia veterinária. 2015:1–110
  PubMed
• 16 Barros M, Gorgal R, Machado AP, Correia A, Montenegro NJAMP. Princípios básicos em cirurgia: fios de sutura. 2011:1051–1056
  PubMed
• 17 Wang W, Degrugillier L, Tremp M. et al. Nerve repair with fibrin nerve conduit and modified suture placement. Anat Rec (Hoboken) 2018; 301 (10) 1690-1696
  CrossrefPubMedGoogle Scholar
• 18 Marinescu S-A, Zărnescu O, Mihai I-R, Giuglea C, Sinescu RDJRJME. An animal model of peripheral nerve regeneration after the application of a collagen-polyvinyl alcohol scaffold and mesenchymal stem cells. Rom J Morphol Embryol 2014; 55 (03) 891-903
  PubMedGoogle Scholar
• 19 Arnold DMJ, Wilkens SC, Coert JH, Chen NC, Ducic I, Eberlin KR. Diagnostic Criteria for Symptomatic Neuroma. Ann Plast Surg 2019; 82 (04) 420-427
  CrossrefPubMedGoogle Scholar
• 20 Neumeister MW, Winters JN. Neuroma. Clin Plast Surg 2020; 47 (02) 279-283
  CrossrefPubMedGoogle Scholar
• 21 de Medinaceli LF. Cell surgery to repair divided nerves: CASIS. 1994
  PubMed