A Study Of Reducing Scar Formation About Sodium Hyaluronate And Autogenous Vein For Nerve Regeneration In Repair Of Peripheral Nerve Injury

Objective: To observe a new method which can reduce formation of scar and neuroma around the repaired peripheral nerves and improve the regeneration and the function of injured nerves. Methods: 60 healthy adult Sprague-Dawley rats were assigned into two groups at random. After both sides of sciatic nerves were transected, 2mm nerve defects were achieved. One side of sciatic defects in both groups were repaired using an epineural suture and acted as self-control. The other side nerve defects in group sodium hyaluronate treatment were repaired with epineural suture and sodium hyaluronate were applied around the site of neurorrhaphy. The other side of nerve defects in group autogenous vein treatment repaired with epineural suture and autogenous veins were used to wrap the neurorrhaphy. Macroscopic and histological evaluations of scarring and nerve regeneration in the repaired sites were performed 4, 8 and 12 weeks post-operation. Electrophysiologic examinations were used to evaluate the function of repaired nerves in both groups.Results: In macroscopic and histological evaluations after 4, 8, 12 weeks post-operation, the forming of scars in the neurorrhaphy treated with sodium hyaluronate was less than its self-control side statistically (P<0.05). The same phenomena were found in the autogenous veins treated side (P<0.05). The electrophysiologic examinations revealed that the latency of nerve conduction of sodium hyaluronate treated sides and autogenous veins treated side were shorter than their self-control sides (P<0.01). The amplitudes of action potentials in both treated sides were higher than their controls (P<0.01). The morphometrical analysis showed that the regeneration ratio and area of myelinated nerve fiber in both treated sides were superior to their control sides (P<0.01). There were not significant differences between sodium hyaluronate treated side and autogenous vein treated side in histology and electrophysiology.Conclusions: The use of sodium hyaluronate and autogenous vein wrapping in the treatment of peripheral nerve defects can reduce the forming of scaring and improve the regeneration of injured nerve.