title: Peripheral nerve reconstruction with collagen tubes filled with denatured autologous muscle tissue in the rat model.
abstract: Conventional nerve conduits lack cellular and extracellular guidance structures critical for bridging larger defects. In this study, an exogenous matrix for axonal regeneration was provided by pretreated muscle tissue. In 24 rats, 14-mm sciatic nerve segments were resected and surgically reconstructed using one of the following methods: autograft (AG); bovine type I collagen conduit; (MDM) collagen tube filled with modified denatured autologous muscle tissue. For 8 weeks, functional regeneration was evaluated by footprint and video gait analysis. Evaluation was complemented by electrophysiology, as well as qualitative and quantitative structural assessment of nerves and target muscles. Group AG was superior both structurally and functionally, showing higher axon counts, a more normal gait pattern, and less severe muscle atrophy. Fiber quality (fiber size and myelin thickness) was highest in group MDM, possibly related to the myelin-producing effect of muscular laminin. However, axon count was lowest in this group, and ultrastructural analysis of the denatured muscle tissue showed areas of incomplete denaturation that had acted as a mechanical barrier for regenerating axons. In light of these results, the often advocated use of muscular exogenous matrix for peripheral nerve reconstruction is reviewed in the literature, and its clinical application is critically discussed. In conclusion, combined muscle tubes may have a positive influence on nerve fiber maturation. However, muscle pretreatment is not without risks, and denaturation processes need to be further refined.
authors.affiliation: Department of Plastic, Reconstructive, Hand and Burn Surgery, Academic Hospital Bogenhausen, Munich 81925, Germany.
authors.forename: Ulf
authors.initials: U
authors.lastname: Dornseifer
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Fichter
authors.forename: Stefan
authors.initials: S
authors.lastname: Leichtle
authors.forename: Andrew
authors.initials: A
authors.lastname: Wilson
authors.forename: Angelika
authors.initials: A
authors.lastname: Rupp
authors.forename: Karsten
authors.initials: K
authors.lastname: Rodenacker
authors.forename: Milomir
authors.initials: M
authors.lastname: Ninkovic
authors.forename: Edgar
authors.initials: E
authors.lastname: Biemer
authors.forename: Hans-Günther
authors.initials: HG
authors.lastname: Machens
authors.forename: Kaspar
authors.initials: K
authors.lastname: Matiasek
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Papadopulos
mesh_terms: D000818:Animals; D001707:Biopsy, Needle; D002417:Cattle; D003094:Collagen / Q000494:pharmacology*; D004195:Disease Models, Animal; D004594:Electrophysiology; D007150:Immunohistochemistry; D008297:Male; D018482:Muscle, Skeletal / Q000637:transplantation*; D009133:Muscular Atrophy / Q000473:pathology; D009416:Nerve Regeneration / Q000502:physiology*; D059348:Peripheral Nerve Injuries / Q000473:pathology / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011897:Random Allocation; D051381:Rats; D011917:Rats, Inbred Lew; D019651:Plastic Surgery Procedures / Q000379:methods*; D012585:Sciatica / Q000473:pathology / Q000601:surgery*; D018709:Statistics, Nonparametric; D020858:Tissue and Organ Harvesting / Q000379:methods; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003094:Collagen