The Study Of Small Gap Coaptation Autologous Epineurium Combined With Nerve Fragments And VEGF In Repairing Damage Of Peripheral Nerve

Objective: In order to provide a research basis for repairing clinical damage of peripheral nerve, we investigated the feasibility and superiority of joint using small gap coaptation autologous epineurium suture, nerve fragments and VEGF in repairing damage of rat sciatic nerve.Methods: The rats were randomly divided into four groups with10rats each. The sciatic nerve was transected and traditional end-to-end anastomosis group (control group) was directly repaired by end-to-end suture of in situ epineurium. Pure small gap autologous epineurium coaptation suture group (experimental group A) adopted small gap autologous epineurium suture to construct a nerve regeneration chamber repair. Small gap autologous epineurium suture plus nerve fragments group (experimental group B) adopted small gap autologous epineurium coaptation suture to construct a nerve regeneration chamber repair and added nerve fragment repair. Small gap autologous epineurium suture plus nerve fragments and VEGF group (experimental group C) adopted small gap autologous epineurium coaptation suture to construct a nerve regeneration chamber repair and added nerve fragment and VEGF repair. Surgery incision, limb swelling, formation of limb-end ulcers and recovery of limb spontaneous movements were observed by and large after operation. Anastomosis and nerve regeneration chamber were observed under microscopy12weeks after operation. Meanwhile, wet-weight ratio of gastrocnemius, nerve electrophysiological analysis, histological evaluation and biopsy image analysis were performed to count the number of spinal nerve fiber and check regenerated axons diameter and myelin thickness.Results:1, General observation:the recovery of limb movement in experimental groups was better than the control group while group C had shortest recovery time. Nerve regeneration chambers in each experimental group were intact and there was no obvious adhesion and neuroma formation in peripheral tissues. The control group had heavier adhesions in anastomotic stoma and peripheral tissues, which showed local expansive growth and neuroma formation.2, nerve electrophysiological analysis showed:the conductive speed of sciatic nerve, group C> B> A> control group.3, the wet-weight ratio of gastrocnemius showed:gastrocnemius recovery in each experimental group was better than the control group and group B and C were better than group A.4, the histology and biopsy image analysis showed:there all existed regenerating nerve fibers in regeneration chambers of each experimental group with even and dense distribution and no neuroma formation. The control group had less nerve fiber regeneration with curly shape, irregular arrangement, neuroma formation and obvious proliferation of connective tissue around anastomotic stoma. The number of spinal nerve fiber, regenerated axons diameter, myelin thickness in biospy image analysis showed:group C> B> A> control group.Conclusions:1, autologous epineurium can be used as excellent conduit to construct nerve regeneration chamber.2, it is feasible to construct nerve regeneration chamber and repair the damage of peripheral nerve by small gap coaptation autologous epineurium and its effects is better than that of traditional end-to-end anastomosis.3, the nerve regeneration chamber constructed by small gap autologous epineurium, are added with nerve fragments and VEGF, which is conducive to form suitable microenvironment for nerve regeneration and promotes nerve regeneration and functional recovery.4, we use small gap coaptation autologous epineurium plus nerve fragments and VEGF to construct nerve regeneration chamber and repair damage of peripheral. This method greatly promotes peripheral nerve regeneration and functional recovery after damage. Our experiments lay the foundation for the study of clinical repair of peripheral nerve damage.