Comparisons of the results of peripheral nerve defect repair with fibrin conduit and autologous nerve graft: An experimental study in rats.

INTRODUCTION: The standard treatment for nerve defects is nerve autograft. There is no conduit available that provides the same regenerative capacity of nerve autograft. This study evaluated the histological and functional recovery of nerve defects treated with fibrin conduit in comparison to the nerve autograft, in a rat model. METHOD: A sciatic nerve injury model (10-mm defect) was performed in 20 Wistar rats, nerve defect was reconstructed using a fibrin conduit (n = 10). A nerve autograft was used as control (n = 10). The walking behavior was measured by footprint analysis at 4, 8, and 12 weeks and sciatic function index was determined. After 12 weeks, histological analysis was performed to evaluate the regenerated nerve and measured axonal density. The triceps surae muscle weight was also evaluated. RESULTS: The fibrin conduit group showed less improvement in walking behavior compared to nerve autograft (-53 ± 2 vs. -36 ± 2; P < 0.001 at 12 weeks). The fibrin conduit group presented axonal density of 40.0 axons/10.995µm2 and the nerve autograft group had 67.2 axons/10.995µm2 (P < 0.001). The triceps surae muscle weight ratio of the fibrin conduit group was 41 ± 3% versus 71 ± 4% of the nerve autograft group (P < 0.001). CONCLUSION: The fibrin conduit could be used for nerve reconstruction following peripheral nerve injury in the rat model. However, the functional recovery in the fibrin conduit repair group was worse than that in nerve autograft group and the nerve repair with the fibrin conduit has less myelinated fibers when compared to the repair with nerve autograft.

Result of microvascular gracilis transplantation for facial paralysis-personal series.

Clinical series of segmental gracilis microvascular transplantation for the treatment of long-standing facial paralysis. Discussion on the evaluation of results and some data obtained from this series.