J Korean Orthop Assoc.  2007 Apr;42(2):162-170. 10.4055/jkoa.2007.42.2.162.

Comparative Study of Scar Formation at the Site of Sciatic Nerve Repair in Rats

Affiliations
  • 1Department of Orthopaedic Surgery, Medical College, Korea University, Seoul, Korea.
  • 2Department of Orthopaedic Surgery, Gil Medical Center, Gachon Medical College, Incheon, Korea. bjr69@paran.com

Abstract

PURPOSE: To investigate the effectiveness and to compare the degree of axonal regeneration with the control after the topical application of dexamethasone, hyaluronic acid and amniotic fluid at the repair site of the peripheral nerve. MATERIALS AND METHODS: The left sciatic nerves of 40 adult Sprague-Dawley rats were transected and neurorrhaphy was performed. The nerves were divided into four groups according to the solution applied around the repair site: control group (group 1), 0.3 ml normal saline: experimental groups, 0.3 ml dexamethasone (group 2), 0.3 ml hyaluronic acid (group 3), and 0.3 ml amniotic fluid (group 4). The thickness of the perineural scar tissue, the count of the myelinated nerve fiber and axonal regeneration on the repair site were evaluated electromyographically and histologically 4 and 12 weeks after surgery. RESULTS: The peak amplitude of the compound motor action potential was observed in group 2, at postoperative 4 weeks and group 3 at postoperative 12 weeks. The increase in the number of myelinated nerve fibers was most prominently in group 3 at 4 and 12 weeks after surgery. The degree of perineural scarring was lowest in group 2 at postoperative 4 weeks and in group 3 at postoperative 12 weeks. CONCLUSION: A single dose topical application of Dexamethasone, HA and Amniotic fluid is more effective in preventing perineural scar formation as well as in facilitating the nerve regeneration process in a rat hind-limb model than using saline.

Keyword

Rat; Sciatic nerve; Dexamethasone; Hyaluronic acid; Amniotic fluid

MeSH Terms

Adult
Male
Female
Humans
Rats
Animals

Figure

  • Fig. 1 Schematic illustration of the number of myelinated nerve fibers.

  • Fig. 2 Schematic illustration showing how the scar tissue thickness was measured.

  • Fig. 3 The mean peak amplitude between each groups 4 and 12 weeks after surgery. The mean peak amplitude was highest in Group 2 4 weeks after surgery and 12 weeks after surgery in Group 3. The data is reported as the mean±SD.

  • Fig. 4 (A) There are a few myelinated nerve fibers and unmyelinated nerve fibers (black arrow) in group 1 4 weeks after surgery (TEM, ×5,000). (B) There are many myelinated nerve fibers (black arrow) 4 weeks (TEM, ×5,000) after surgery in group 3.

  • Fig. 5 (A) A few myelinated nerve fibers and unmyelinated nerve fibers were observed 12 weeks (TEM, ×5,000) after surgery in group 1. (B) Increased number of myelinated nerve fibers and unmyelinated nerve fibers is 12 weeks (TEM, ×5,000) after surgery in group 3.

  • Fig. 6 The mean axonal count among each group in 4 and 12 weeks after surgery. The data is reported as the mean±SD.

  • Fig. 7 Longitudinal sections of the sciatic nerves taken at the repair site 4 weeks after surgery. (A) Nerve applied with saline (group 1) showing a dense band of connective scar tissue surrounding the nerve (toluidine blue, LM, ×400). (B) Nerve applied with dexamethasone (group 2) showing a thin layer of epineural scar tissue (toluidine blue, LM, ×400).

  • Fig. 8 Longitudinal sections of the sciatic nerves taken at the repair site 12 weeks after surgery. (A) Nerve applied with saline (group 1) showing an increase in connective scar tissue surrounding the nerve (toluidine blue, LM, ×400). (B) Nerve applied with HA (group 3) showing significantly less epineural scar tissue (toluidine blue, LM, ×400).

  • Fig. 9 The mean perineural scar thickness between each group 4 and 12 weeks after surgery. The data is reported as the mean±SD.


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