The Experimental Study Of The Secondary Surgical Treatment On Distal Stoma Of Nerve Graft To Promote Axon Regeneration

The experimental study of the secondary surgical treatment on distal stoma of nerve graft to promote axon regenerationThe treatment of peripheral nerve defects has been the enormous challenges faced by surgeons. Nerve grafting is the best option for the treatment of long nerve defect so far, although allogeneic, xenogeneic, non-neural tissues, engineering nerves and other alternative materials methods has been researched. The survival of long nerve graft undergoes ischemic changes after nerve injured, the nerve fiber mismatch growth, neuroma formation and other factors degenerated the ablity of endogenous axon regeneration.When cross-jump portable two anastomotic easily blocked the distal anastomosis of scarring. Therefore, improving the autologous nerve graft should pay more attention to protect neurons and reduce scarring obstruction to regenerating axons.The nerve grafting model of sciatic nerve in Wistar rats was founded. All rats were divided into three groups:sham operation group (the sciatic nerve was exposed only), control group (the sciatic nerve was cut at two levels, one was at the lower border of piriformis and the other was15mm distal to this point) and experimental group (the sciatic nerve was treated as control group but the distal stoma was retreated8weeks latter).The GAP-43was detected through RT-PCR, and Western blot according to time of nerve grafting and retreatment, and16and20weeks after the first surgery, the axonal regeneration and nerve electrical physiological functions were detected.The results show that:1, GAP-43in the spinal cord after the first and second surgery have an increased trend.In2weeks control group reached the only peak after the first surgery2, After16weeks the second surgery on the distal stoma of grafting nerve, comparing with control group the nerve conduction velocity and amplitude attenuation rate of the experimental group indicates no significant difference. After20weeks the experimental and control group, the experimental group and control group in the nerve conduction velocity, amplitude attenuation rate and other electrophysiological indicates significant differences. Second surgery on distal stoma of the grafting nerve, experimental group and control group after16weeks, nerve axons fiber regeneration,the total area, the average space distance, the axon area recovery rate indicates no significant difference; after20weeks, the experimental group and control group are still no significant difference; in leap distal stoma and the transplanted nerve segment two anastomotic, compared with the experimental group and control group, the average space between axons of the total area, total axon area recovery rate indicators significant difference.Conclusion:The second surgical treatment of distal stoma of grafting nerve will re-induce the axonal regeneration capacity of neuron and clear the distal anastomosis scar which shackles of the regenerating axons; The second surgical treatment of distal stoma can improve axonal regeneration, recovering nerve conduction, and then improving the efficacy of nerve graft,develope a new scientific ideas and techniquesor for clinical application.