In vivo and in vitro degradation of poly[(50)/(50) ((85)/(15)(L)/(D))LA/epsilon-CL], and the implications for the use in nerve reconstruction.
Nerve guides can be used for the reconstruction of peripheral nerve defects. After serving their function, nerve guides should degrade. p[(50)/(50) ((85)/(15)(L)/(D))LA/epsilon-CL] degrades completely within 1 year without the formation of a slow degrading crystalline fraction. Although the tensile strength (TS) of a p[(50)/(50) ((85)/(15)(L)/(D))LA/epsilon-CL] nerve guide is negligible after 2 months, nerve regeneration across a 1-cm gap in the sciatic nerve of the rat is faster and qualitatively better than after reconstruction using autologous nerve grafts. During degradation p[(50)/(50) ((85)/(15)(L)/(D))LA/epsilon-CL] swells, especially during the first 3 months. This can have a negative influence on the regenerating nerve. p[(50)/(50) ((85)/(15)(L)/(D))LA/epsilon-CL] nerve guides could only be used in the clinical situation in case of short nerve gaps (several mm) in small nerves (for instance digital nerves). Refinements will be needed to successfully reconstruct longer nerve gaps (several cm).
den Dunnen
W F
WF
Department of Pathology, Groningen University Hospital, Hanzeplein 1, 9713 GZ Groningen, The Netherlands. wfadendunnen@yahoo.com
Meek
M F
MF
Grijpma
D W
DW
Robinson
P H
PH
Schakenraad
J M
JM
D000818:Animals; D001672:Biocompatible Materials / Q000737:chemistry / Q000378:metabolism*; D001673:Biodegradation, Environmental; D003460:Crystallization; D066298:In Vitro Techniques; D008422:Materials Testing; D008970:Molecular Weight; D009416:Nerve Regeneration; D010525:Peripheral Nerves / Q000502:physiology / Q000601:surgery*; D011091:Polyesters / Q000737:chemistry / Q000378:metabolism*; D051381:Rats; D012584:Sciatic Nerve / Q000502:physiology / Q000601:surgery / Q000637:transplantation; D013718:Tensile Strength; D014182:Transplantation, Autologous
D001672:Biocompatible Materials; D011091:Polyesters; C062968:lactide-caprolactone copolymer