Long-term result of guided nerve regeneration with an inert microporous polytetrafluoroethylene conduit.
OBJECTIVE
To evaluate the long-term outcome of Polytetrafluoroethylene (PTFE) conduit in nerve repair and to provide more evidence in view of its potential application to achieve a satisfactory functional recovery in clinical settings.


METHODS
Thirty-six Wistar rats had their right sciatic nerve transected and were repaired with either conventional microsuture technique (Control group, n=18) or a PTFE conduit with a gap of 5 mm left between the nerve stumps (PTFE group, n=18). At 6 and 9 months after the operation, electrophysiological assessment and measurement of gastrocnemius muscle weight were conducted and morphology of the regenerated nerves were studied with image analysis.


RESULTS
At 6 months postoperatively, the nerve conduction velocity recovered to 60.86% and 54.36% (P<0.05), and the gastrocnemius muscle weight recovered to 50.89% and 46.11% (P>0.05) in the Control group and the PTFE group respectively. At 9 months postoperatively, the recovery rate was 65.99% and 58.79% for NCV (P>0.05), and 52.56% and 47.89% for gastrocnemius muscle weight (P>0.05) in the Control group and the PTFE group respectively. Regenerated nerve fibers in the PTFE group had a regular round shape with no fragmentation, wrinkling or splitting of the myelin sheath. Image analysis revealed that the ratio of the myelin area to the total fiber area was larger at 9 months than at 6 months in both groups (P<0.01).


CONCLUSIONS
Microporous PTFE conduit may be an alternative for nerve repair allowing of guided nerve regeneration and functional recovery with no obvious adverse effect at long-term.
Department of Orthopaedics, Foshan Hospital of Traditional Chinese Medicine, Guangdong 528000, China. hefch2001@hotmail.com
Feng-chun
FC
He
Qing-yu
QY
Fan
Timothy R
TR
Cushway
Robbert
R
De Iongh
Marco
M
Lanzetta
Pierluigi
P
Tos
Earl R
ER
Owen
D000818:Animals; D001672:Biocompatible Materials; D008297:Male; D008866:Microsurgery; D009186:Myelin Sheath; D009416:Nerve Regeneration; D011138:Polytetrafluoroethylene; D019736:Prostheses and Implants; D051381:Rats; D017208:Rats, Wistar; D012584:Sciatic Nerve / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D013997:Time Factors
D001672:Biocompatible Materials; D011138:Polytetrafluoroethylene