title: Hyaluronic acid/carboxymethyl cellulose directly applied to transected nerve decreases axonal outgrowth.
abstract: Neuroma management is an unresolved problem. Biomaterials to limit unwanted axonal growth could be a tool to manage neuroma. Hyaluronic acid/carboxymethyl cellulose (HA/CMC) is an antiadhesive, biodegradable material that is nontoxic to nerve. The purpose of this study was to evaluate the efficacy of this biomaterial to limit axonal growth. Rats received a sciatic nerve transection and repair with a short conduit (5 mm) containing HA/CMC, fibrin, or nothing (empty conduit). In another study, nerve was transected and either left undisturbed or wrapped with HA/CMC around the proximal and distal ends. In a final study, nerve was transected and repaired with an HA/CMC wrap. Four weeks following the procedures, nerves were harvested and assessed using histomorphometry to measure axonal regeneration. Axonal regeneration following transection was significantly inhibited by direct axonal contact with HA/CMC, whether within a conduit or wrapped around the transected proximal nerve end. Axonal regeneration following epineurial repair was not affected by HA/CMC wrapped around nerve, demonstrating axonal growth inhibition due to direct contact of regenerating axons with HA/CMC. These studies demonstrate the efficacy of HA/CMC to limit axonal outgrowth by contact with regenerating axons. HA/CMC barriers may prove to be a tool to prevent neuroma formation by inhibiting axonal growth. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 568-574, 2017.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Aouod
authors.initials: A
authors.lastname: Agenor
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Lucas
authors.initials: L
authors.lastname: Dvoracek
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Ann
authors.initials: A
authors.lastname: Leu
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hunter
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Piyaraj
authors.initials: P
authors.lastname: Newton
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Johnson
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Moore
authors.affiliation: Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, 63110.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Wood
mesh_terms: D000818:Animals; D001369:Axons / Q000502:physiology*; D002266:Carboxymethylcellulose Sodium / Q000737:chemistry / Q000494:pharmacology; D006820:Hyaluronic Acid / Q000737:chemistry / Q000494:pharmacology; D008297:Male; D009463:Neuroma / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control; D051381:Rats; D011917:Rats, Inbred Lew; D012038:Regeneration / Q000187:drug effects*; D012584:Sciatic Nerve / Q000293:injuries / Q000378:metabolism / Q000473:pathology
chemical_list: D006820:Hyaluronic Acid; D002266:Carboxymethylcellulose Sodium
keywords: axon growth; hyaluronate; hyaluronic acid; neuroma; peripheral nerve