DuraSeal as a ligature in the anastomosis of rat sciatic nerve gap injury.
BACKGROUND
Anastomosis of the nerve especially at narrow surgical field and presence of surgical tension is not easily accessible. DuraSeal demonstrates strong adhesive power without producing neurotoxicity. Herein, we evaluate the possibility of DuraSeal as a substitute in the repair of sciatic nerve gap injury.


METHODS
The nerve gap model was constructed by excising the sciatic nerve (5mm in length) in Sprague Dawley rats leaving a 5mm nerve defect between nerve stumps. Animals were categorized into four groups: Group I: no treatment; Group II: 4 stitches suture; Group III: nerve approximation fixed by tissue glue; Group IV: nerve approximation fixed by DuraSeal. The motor function assessment included the CatWalk and SFI as well as electrophysiological studies. Nerve continuity and regeneration was examined at 1 and 8 wk after injury. The inflammatory cells, Schwann cell apoptosis, and Schwann cell proliferation were also investigated 1 wk after injury.


RESULTS
The achievement of nerve continuity and myelination by DuraSeal approached that of suture demonstrated by crystal violet and Luxol Fast Blue staining at 1 and 8 wk, respectively. Motor function and electrophysiological parameters were restored in DuraSeal and suture group. Early expression of neurofilament and bromodeoxyuridine (BrdU) was also observed in these two groups. There was no statistically significant difference in deposits of macrophages and neutrophil cells or cell apoptosis among these four groups.


CONCLUSIONS
DuraSeal achieved the same nerve regeneration compared with that of suture and produced better regeneration than that of the tissue glue or without any treatment. The accomplishment of nerve regeneration and continuity without causing neurotoxicity justifies using DuraSeal as a ligature in the anastomosis of nerve gap injury.
Lin
Kai-Li
KL
Department of Chemical Engineering, National Tsing Hua University, Hsinyhu Taiwan.
Yang
Dar-Yu
DY
Chu
I-Min
IM
Cheng
Fu-Chou
FC
Chen
Chun-Jung
CJ
Ho
Shu-Peng
SP
Pan
Hung-Chuan
HC
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D017209:Apoptosis; D004558:Electric Stimulation; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use; D009416:Nerve Regeneration; D051381:Rats; D017207:Rats, Sprague-Dawley; D012117:Resins, Synthetic / Q000627:therapeutic use* / Q000633:toxicity; D012584:Sciatic Nerve / Q000293:injuries* / Q000502:physiology; D020426:Sciatic Neuropathy / Q000276:immunology / Q000601:surgery*; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*
D015718:Fibrin Tissue Adhesive; D012117:Resins, Synthetic; D014014:Tissue Adhesives; C030189:Dura-Seal