Polyethylene Glycol Fusion Restores Axonal Continuity and Improves Return of Function in a Rat Median Nerve Denervation Model.

Autor:	Frost C; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Salous A; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Ketheeswaran S; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Ngaage LM; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Hanwright PJ; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Ghergherehchi C; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine.; Department of Neuroscience, University of Texas at Austin., Tuffaha S; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Vaidya D; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Bittner GD; Department of Neuroscience, University of Texas at Austin., Brandacher G; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine., Shores JT; From the Department of Plastic and Reconstructive Surgery, Johns Hopkins University School of Medicine.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery [Plast Reconstr Surg] 2024 Sep 01; Vol. 154 (3), pp. 563-571. Date of Electronic Publication: 2023 Sep 19.
DOI:	10.1097/PRS.0000000000011068
Abstrakt:	Background: Polyethylene glycol (PEG) can fuse severed closely apposed axolemmas and restore axonal continuity. The authors evaluated the effects of PEG fusion on functional recovery in a rodent forelimb model of peripheral nerve injury. Methods: The median nerves of male Lewis rats ( n = 5 per group) were transected and repaired with standard suture repair (SR), SR with PEG (PEG), or SR with PEG and 1% methylene blue (PEG+MB); a sham surgery group was also included. Proximal stimulation produced compound nerve and muscle action potentials recorded distally. The contralateral limb of each animal acted as an internal control for grip strength measurements. Results: Compound nerve and muscle action potentials immediately returned in all PEG and PEG+MB animals, but not in SR animals. The PEG and PEG+MB groups demonstrated earlier return of function by postoperative day (POD) 7 (62.6 ± 7.3% and 50.9 ± 6.7% of contralateral limb grip strength, respectively) compared with the SR group, in which minimal return of function was not measurable until POD 21. At POD 98, the PEG group grip strength recovered to 77.2 ± 2.8% and the PEG+MB grip strength recovered to 79.9 ± 4.4%, compared with 34.9 ± 1.8% recovery in the SR group ( P < 0.05). The PEG and PEG+MB groups reached 50% of the sham group grip strength on POD 3.8 and POD 6.3, respectively, whereas the SR group did not reach 50% grip strength recovery of the sham group throughout the study period. Conclusion: PEG fusion plus neurorrhaphy with or without MB reestablished axonal continuity, shortened recovery time, and augmented functional recovery compared with suture neurorrhaphy alone. Clinical Relevance Statement: PEG fusion with neurorrhaphy may bypass Wallerian degeneration, leading to augmented and shortened functional recovery. (Copyright © 2023 by the American Society of Plastic Surgeons.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu