Bridging the Gap: Engineered Porcine-derived Urinary Bladder Matrix Conduits as a Novel Scaffold for Peripheral Nerve Regeneration.
OBJECTIVE
This study aims to compare engineered nerve conduits constructed from porcine-derived urinary bladder matrix (UBM) with the criterion-standard nerve autografts, for segmental loss peripheral nerve repairs.


METHODS
Forty-eight Sprague-Dawley rats were divided into 2 groups. All underwent a 10-mm sciatic nerve gap injury. This was repaired using either (1) reverse autograft-the 10-mm cut segment was oriented 180 degrees and used to coapt the proximal and distal stumps or (2) UBM conduit-the 10-mm nerve gap was bridged with UBM conduit. Behavior assessments such as sciatic function index and foot fault asymmetry scores were performed weekly. At 3- or 6-week time endpoints, the repaired nerves and bilateral gastrocnemius/soleus muscles were harvested from each animal. Nerves were evaluated using immunohistochemistry for motor and sensory axon staining and with diffusion tensor imaging. The net wet muscle weights were calculated to assess the degree of muscle atrophy.


RESULTS
The UBM group demonstrated significantly improved foot fault asymmetry scores at 2 and 4 weeks, whereas there was no difference in sciatic function index. The net muscle weights were similar between both groups. Motor axon counts proximal/inside/distal to the conduit/graft were similar between UBM conduits and reverse autografts, whereas sensory axon counts within and distal to the conduit were significantly higher than those of the autograft at 6 weeks. Sensory axonal regeneration seemed to be adherent to the inner surface of the UBM conduit, whereas it had a scattered appearance in autografts. Diffusion tensor imaging parameters between groups were similar.


CONCLUSIONS
Urinary bladder matrix conduits prove to be at least similar to nerve autografts for the repair of peripheral nerve injuries with a short gap. The matrix perhaps serves as a scaffold to augment sensory nerve growth.


CONCLUSIONS
In a clinical setting, UBM may eliminate the donor site morbidity and increased operative time associated with nerve autografting.
From the Departments of *Plastic Surgery, and †Biomedical Engineering, and ‡Institute of Imaging Science, Vanderbilt University Medical Center, Nashville, TN; §Department of Surgery, Morristown Medical Center, Morristown, NJ; ∥Department of Surgery, University of South Carolina, Columbia, SC.
Lyly
L
Nguyen
Ashkan
A
Afshari
Nathaniel D
ND
Kelm
Alonda C
AC
Pollins
R Bruce
RB
Shack
Mark D
MD
Does
Wesley P
WP
Thayer
D000818:Animals; D064592:Autografts; D056324:Diffusion Tensor Imaging; D004195:Disease Models, Animal; D005260:Female; D009416:Nerve Regeneration / Q000502:physiology*; D059348:Peripheral Nerve Injuries / Q000601:surgery; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D012307:Risk Factors; D012584:Sciatic Nerve / Q000293:injuries* / Q000601:surgery; D012680:Sensitivity and Specificity; D013552:Swine; D023822:Tissue Engineering; D054457:Tissue Scaffolds; D001743:Urinary Bladder / Q000000981:diagnostic imaging / Q000601:surgery; D014547:Urinary Diversion