Photochemical tissue bonding: a promising technique for peripheral nerve repair.
BACKGROUND
Photochemical tissue bonding (PTB) is a novel tissue repair technique that uses visible light and a photosensitizing dye to crosslink proteins on tissue surfaces. This technique has been successfully demonstrated in a number of tissue repair models. An ideal nerve repair technique would be atraumatic and avoid placement of foreign bodies at the repair site. The epineurium is suited to photochemical repair as it is thin, translucent and has a relatively high collagen content. This study was designed to determine if PTB could be successfully applied in a peripheral nerve repair model.


METHODS
Forty Sprague Dawley rats underwent transection of the sciatic nerve. Animals were then randomized to four treatment groups; epineurial suture repair, epineurial cuff with PTB, epineurial cuff alone, and no repair. Functional recovery was assessed at 10 day intervals using walking track analysis and sciatic function index calculations. At 90 days postoperatively animals were sacrificed and sciatic nerves harvested for histology and histomorphometry.


RESULTS
Functional recovery in the suture repair and epineural cuff with PTB groups were not significantly different (-70.6 +/- 17.8 versus -76.9 +/- 10.3, P = 0.64) at 90 days postrepair. Histology showed good axonal regeneration with all repair techniques. Histomorphometric analysis found no significant difference between the repair groups.


CONCLUSIONS
This study illustrates that peripheral nerves can be successfully repaired using a photochemical tissue bonding technique with results similar to those achieved with the current gold standard. With further development and refinement PTB may prove a useful tool in peripheral nerve repair.
Johnson
T Shane
TS
Plastic Surgery Research Laboratory, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
O'Neill
Anne C
AC
Motarjem
Pejman M
PM
Amann
Christopher
C
Nguyen
Tuan
T
Randolph
Mark A
MA
Winograd
Jonathan M
JM
Kochevar
Irene E
IE
Redmond
Robert W
RW
D000818:Animals; D003131:Combined Modality Therapy; D003432:Cross-Linking Reagents / Q000494:pharmacology*; D008027:Light; D008297:Male; D018482:Muscle, Skeletal / Q000294:innervation; D009413:Nerve Fibers, Myelinated / Q000187:drug effects / Q000473:pathology; D010525:Peripheral Nerves / Q000187:drug effects / Q000473:pathology / Q000502:physiology; D010778:Photochemotherapy / Q000379:methods*; D051381:Rats; D017207:Rats, Sprague-Dawley; D020426:Sciatic Neuropathy / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D013537:Sutures; D014014:Tissue Adhesives / Q000494:pharmacology*; D014945:Wound Healing / Q000187:drug effects
D003432:Cross-Linking Reagents; D014014:Tissue Adhesives