Induced Pseudomembrane Enrichment in Long Nerve Allograft Reconstruction

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Autori principali: Omar A. Protzuk, Mariam A. Samuel, Kriston R. Seward, Christopher A. Keshishian, Geetanjali S. Bendale, Jonathan E. Isaacs
Natura: Artículo Open Access
Pubblicazione: Wiley 2025
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author Omar A. Protzuk
Mariam A. Samuel
Kriston R. Seward
Christopher A. Keshishian
Geetanjali S. Bendale
Jonathan E. Isaacs
author_facet Omar A. Protzuk
Mariam A. Samuel
Kriston R. Seward
Christopher A. Keshishian
Geetanjali S. Bendale
Jonathan E. Isaacs
Omar A. Protzuk
Mariam A. Samuel
Kriston R. Seward
Christopher A. Keshishian
Geetanjali S. Bendale
Jonathan E. Isaacs
collection Wiley Open Access
contents Induced Pseudomembrane Enrichment in Long Nerve Allograft Reconstruction Omar A. Protzuk Mariam A. Samuel Kriston R. Seward Christopher A. Keshishian Geetanjali S. Bendale Jonathan E. Isaacs Muscle & Nerve ABSTRACTIntroduction/AimsLong nerve defects are typically reconstructed with autograft or processed acellular nerve allograft (PNA). PNA is convenient and avoids donor morbidity but lacks the neurotrophic environment of autograft. Increased levels of neurotrophic factors have been identified in pseudomembranes induced around silicone implanted between nerve ends. This study aimed to determine if pseudomembrane can be reliably induced around silicone implanted between nerve ends, and if this enhances regeneration of PNA inset within using a staged technique.MethodsLewis rats (n = 24) underwent resection of a 15‐mm sciatic nerve. The defect was filled with a silicone tube (n = 12) (MA) or the nerve ends were secured to a muscle bed (n = 12) (NMA). After 4 weeks, the silicone was replaced with PNA threaded within the pseudomembrane tunnel. In both groups, PNA was used to reconstruct the nerve defect. Weekly neuromotor assessment was performed with sciatic function index (SFI). At 16 weeks, muscle recovery was assessed, and nerve samples were obtained for histomorphometry.ResultsThe MA group's average normalized muscle weight was 46.25% versus the NMA group's 33.19% (p < 0.05). The MA group's average normalized muscle girth was 78.25% versus the NMA group's 60.73% (p < 0.05). Axon counts, g‐ratio, and muscle force were not statistically different. At Week 15, the MA group had a significantly higher average SFI: −82.25 versus the NMA group −95.03 (p < 0.05).DiscussionPNA inset within induced pseudomembrane sheath enhanced muscle reinnervation. A staged membrane enhancement technique may be effective for improving PNA efficacy in peripheral nerve injury reconstruction. 10.1002/mus.28362 http://creativecommons.org/licenses/by-nc-nd/4.0/
doi_str_mv 10.1002/mus.28362
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id wiley_oa_10_1002_mus_28362
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
publishDate 2025
publisher Wiley
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spellingShingle Induced Pseudomembrane Enrichment in Long Nerve Allograft Reconstruction
Omar A. Protzuk
Mariam A. Samuel
Kriston R. Seward
Christopher A. Keshishian
Geetanjali S. Bendale
Jonathan E. Isaacs
Muscle & Nerve
Induced Pseudomembrane Enrichment in Long Nerve Allograft Reconstruction Omar A. Protzuk Mariam A. Samuel Kriston R. Seward Christopher A. Keshishian Geetanjali S. Bendale Jonathan E. Isaacs Muscle & Nerve ABSTRACTIntroduction/AimsLong nerve defects are typically reconstructed with autograft or processed acellular nerve allograft (PNA). PNA is convenient and avoids donor morbidity but lacks the neurotrophic environment of autograft. Increased levels of neurotrophic factors have been identified in pseudomembranes induced around silicone implanted between nerve ends. This study aimed to determine if pseudomembrane can be reliably induced around silicone implanted between nerve ends, and if this enhances regeneration of PNA inset within using a staged technique.MethodsLewis rats (n = 24) underwent resection of a 15‐mm sciatic nerve. The defect was filled with a silicone tube (n = 12) (MA) or the nerve ends were secured to a muscle bed (n = 12) (NMA). After 4 weeks, the silicone was replaced with PNA threaded within the pseudomembrane tunnel. In both groups, PNA was used to reconstruct the nerve defect. Weekly neuromotor assessment was performed with sciatic function index (SFI). At 16 weeks, muscle recovery was assessed, and nerve samples were obtained for histomorphometry.ResultsThe MA group's average normalized muscle weight was 46.25% versus the NMA group's 33.19% (p < 0.05). The MA group's average normalized muscle girth was 78.25% versus the NMA group's 60.73% (p < 0.05). Axon counts, g‐ratio, and muscle force were not statistically different. At Week 15, the MA group had a significantly higher average SFI: −82.25 versus the NMA group −95.03 (p < 0.05).DiscussionPNA inset within induced pseudomembrane sheath enhanced muscle reinnervation. A staged membrane enhancement technique may be effective for improving PNA efficacy in peripheral nerve injury reconstruction. 10.1002/mus.28362 http://creativecommons.org/licenses/by-nc-nd/4.0/
title Induced Pseudomembrane Enrichment in Long Nerve Allograft Reconstruction
topic Muscle & Nerve
url https://onlinelibrary.wiley.com/doi/10.1002/mus.28362