Relevance. The investigations on trauma epidemiology have shown that both combat- and noncombat-related extremity injuries are often accompanied by nerve injuries. These injuries disproportionately affect young healthy civilians and military officers and has a devastating impact on a patients’ quality of life.
Severe nerve injuries, such as nerve trunk injury in continuity (Sunderland 5), that cannot be treated by neurorraphy without tension, require use of nerve gap bridging strategies with different materials and techniques.
Objective. This study was aimed to evaluate any positive or negative impact of implanted silicon wires on the quality of nerve fibers at distal nerve stump.
Materials and Methods. An experiment was performed on 40 male Whistar rats 2-4 month that were divided to the next groups:
I, (n=10) sham-operated, only surgical access to sciatic nerve was performed.
II (n=10) with 10 mm sciatic nerve gap that was bridged with autoneurografting.
III (n=10) with 10 mm nerve gap that was bridged with allogenic decell aorta filled with 4% carboxymethylcellulose hydrogel.
IV (n=10) with 10 mm nerve gap that was bridged with allogenic decell aorta filled with 4% carboxymethylcellulose hydrogel and aligned p-type silicon microvires.
Decellularization of allogenic aortas was performed by freeze-thaw cycles.
Silicon whiskers were fabricated by Vapor-Liquid-Solid (VLS) method in a cold wall Catalytic Chemical Vapor Deposition (Cat-CVD) chamber, pre-cleaned with hydrofluoric acid and sterilized via 180*C dry heat.
12 weeks after surgery under general anesthesia all rats underwent invasive needle electroneurpmyography with proximal nerve stump stimulation and registration from gastrocnemius muscle. Myograms were recorded and compared by the shape of M-reflex and its amplitude.
After myography rats were euthanized under thiopentone overdosage and distal stumps of injured sciatic nerves were harvested for light microscopy.
Sciatic nerve transverse slices were stained with nitric silver by modified Bielschowsky method Nerve fiber diameter, axon diameter, myelin sheath thickness and axon-to-nerve fiber diameter ratio (g-ratio) were measured.
Results. Performed analysis showed that rats from ІІ and IV groups demonstrated the best quality of nerve fibers in distal nerve stump. That was evidenced by bigger nerve fibers diameter in rats from autologous nerve grafting group and aorta with gel and wires grafting group in comparison with aorta with gel grafting group. Rats from IV demonstrated higher voltage and lower latency of M-reflexes during electromyography.
Conclusions. It can be concluded about the possible pro-regenerative impact of implanted silicon wires that was evidenced by better nerve fibers quality at distal nerve stump.
2. Taylor C, Braza D, Rice J, Dillingham T. The Incidence of Peripheral Nerve Injury in Extremity Trauma // American Journal of Physical Medicine & Rehabilitation. 2008; 87 (5): 381-5. https://doi.org/10.1097 / PHM.0b013e31815e6370
3. Saadat S, Eslami V, Rahimi-movaghar V. The incidence of peripheral nerve injury in trauma patients in Iran // Turkish Journal of Trauma and Emergency Surgery. 2011; 17 (6): 539-44. https://doi.org/10.5505 / tjtes.2011.75735
4. Shin E, Sabino J, Nanos G, Valerio I. Ballistic Trauma: Lessons Learned from Iraq and Afghanistan // Seminars in Plastic Surgery. 2015; 29 (1): 10-9. https://doi.org/10.1055 / s-0035-1544173
5. Vasileiadis A. Bridging of Peripheral Nerve Defects by Autologous Nerve Grafting Personal Experience // MOJ Orthopedics & Rheumatology. 2016; 5 (3): 1-16. https://doi.org/10.15406/mojor.2016.05.00183
6. Hunt T, Wiesel S. Operative techniques in hand, wrist, and forearm surgery. Philadelphia: Lippincott Williams & Wilkins; 2011. ISBN-13: 978-1451102550 URL: https://www.amazon.com/Operative-Techniques-Wrist-Forearm-Surgery-ebook/dp/B007IVBNZU
7. Pi H, Gao Y, Wang Y, Kong D, Qu B, Su X et al. Nerve autografts and tissue-engineered materials for the repair of peripheral nerve injuries: a 5-year bibliometric analysis // Neural Regeneration Research. 2015; 10 (6): 1003-8. https://doi.org/10.4103/1673-5374.158369
8. Geraschenko S, Deltsova O, Kolomiitsev A, Chaikovsky Y. [Periferiynyi nerv (neiro-sudynno-desmalni vzaiemovidnoshennya v normi i pry patologii)] / ISBN 966-673-069-3. 1st ed. Ternopil: Ukrmedknyha; 2005. [in Ukrainian] URL: http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?Z21ID=&I21DBN=REF&P21DBN=REF&S21STN=1&S21REF=10&S21FMT=fullwebr&C21COM=S&S21CNR=20&S21P01=0&S21P02=0&S21P03=A=&S21COLORTERMS=1&S21STR=%D0%94%D1%94%D0%BB%D1%8C%D1%86%D0%BE%D0%B2%D0%B0%20%D0%9E$
9. Raimondo S, Fornaro M, Di Scipio F, Ronchi G, Giacobini‐Robecchi M, Geuna S. Chapter 5 Methods and Protocols in Peripheral Nerve Regeneration Experimental Research // International Review of Neurobiology. 2009; 87: 81-103. https://doi.org/10.1016 / S0074-7742 (09) 87005-0.
10. Chiono V, Tonda‐Turo C, Ciardelli G. Chapter 9 Artificial Scaffolds for Peripheral Nerve Reconstruction // International Review of Neurobiology. 2009; 87:173-98. https://doi.org/10.1016 / S0074-7742 (09) 87009-8.
11. Dahlin L, Johansson F, Lindwall C, Kanje M. Chapter 28 Future Perspective in Peripheral Nerve Reconstruction // International Review of Neurobiology. 2009; 87: 507-30. https://doi.org/10.1016 / S0074-7742 (09) 87028-1
12. Dietzmeyer N, Förthmann M, Leonhard J, Helmecke O, Brandenberger C, Freier T et al. Two-Chambered Chitosan Nerve Guides With Increased Bendability Support Recovery of Skilled Forelimb Reaching Similar to Autologous Nerve Grafts in the Rat 10 mm Median Nerve Injury and Repair Model // Frontiers in Cellular Neuroscience. 2019; 13: 149. https://doi.org/10.3389 / fncel.2019.00149.
13. Wang S, Cai L. Polymers for Fabricating Nerve Conduits // International Journal of Polymer Science. 2010; 2010: Article ID 138686, 1-20. http://dx.doi.org/10.1155/2010/138686
14. Ordonez J, Boehler C, Schuettler M, Stieglitz T. Improved polyimide thin-film electrodes for neural implants // Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2012; 2012: 5134-7. https://doi.org/10.1109/EMBC.2012.6347149.
15. Singh A, Shiekh P, Das M, Seppälä J, Kumar A. Aligned Chitosan-Gelatin Cryogel-Filled Polyurethane Nerve Guidance Channel for Neural Tissue Engineering: Fabrication, Characterization, and In Vitro Evaluation // Biomacromolecules. 2019; 20 (2): 662-73. https://doi.org/10.1021/ acs.biomac.8b01308.
16. Yu W, Zhao W, Zhu C, Zhang X, Ye D, Zhang W et al. Sciatic nerve regeneration in rats by a promising electrospun collagen/poly(ε-caprolactone) nerve conduit with tailored degradation rate // BMC Neuroscience. 2011; 12 (1): 68. https://doi.org/10.1186 / 1471-2202-12-68.
17. Suzuki K, Kawauchi A, Nakamura T, Itoi S, Ito T, So J et al. Histologic and Electrophysiological Study of Nerve Regeneration Using a Polyglycolic Acid-collagen Nerve Conduit Filled With Collagen Sponge in Canine Model // Urology. 2009; 74 (4): 958-63. https://doi.org/10.1016 / j.urology.2009.02.057.
18. Navarro X, Udina E. Chapter 6. Methods and Protocols in Peripheral Nerve Regeneration Experimental Research // International Review of Neurobiology. 2009; 87:105-126. https://doi.org/10.1016 / S0074-7742 (09) 87006-2.
19. Alvites R, Rita Caseiro A, Santos Pedrosa S, Vieira Branquinho M, Ronchi G, Geuna S et al. Peripheral nerve injury and axonotmesis: State of the art and recent advances // Cogent Medicine. 2018; 5 (1): 1-22. URL: https://www.tandfonline.com/doi/full/10.1080/2331205X.2018.1466404
20. Mills S. Histology for pathologists. Philadelphia; 2007. ISBN: 1496398947
21. Deumens R, Bozkurt A, Meek M, Marcus M, Joosten E, Weis J et al. Repairing injured peripheral nerves: Bridging the gap // Progress in Neurobiology. 2010; 92 (3): 245-76. https://doi.org/10.1016 / j.pneurobio.2010.10.002.
22. Flecknell P. Laboratory Animal Anaesthesia Ed. 4. Academic Press; 2015. ISBN 978-0-12-800036-6
23. Klimovskaya A, Kalashnyk Y, Voroshchenko A, Oberemok O, Pedchenko Y, Lytvyn P. Growth of silicon self-assembled nanowires by using gold-enhanced CVD technology // Semiconductor Physics, Quantum Electronics and Optoelectronics. 2018; 21 (3): 282-7. https://doi.org/10.15407/spqeo21.03.282 URL: https://www.researchgate.net/publication/328814565_Growth_of_silicon_self-assembled_nanowires_by_using_gold-enhanced_CVD_technology
24. Reinhardt K, Kern W. Handbook of silicon wafer cleaning technology. Norwich, NY: William Andrew; 2008. ISBN: 9780815517733
25. Kolomiitsev A K, Chaikovsky Yu B, Tereschenko T L. Fast method of peripheral nervous system nitric silver impregnation suitable for celloidine and parafine slices // Archives of anatomy, histology and embryology. 1981; 8: 93-6. [in Russian]
26. Hoffman P. Review: The Synthesis, Axonal Transport, and Phosphorylation of Neurofilaments Determine Axonal Caliber in Myelinated Nerve Fibers // The Neuroscientist. 1995; 1 (2): 76-83. https://doi.org/10.1177/107385849500100204
27. Sanders S. The thickness of the myelin sheaths of normal and regenerating peripheral nerve fibres. Proceedings of the Royal Society of London Series B - // Biological Sciences. 1948; 135 (880): 323-57. https://doi.org/10.1098/ rspb.1948.0015
28. Rafuse V, Gordon T. Self-reinnervated cat medial gastrocnemius muscles. I. comparisons of the capacity for regenerating nerves to form enlarged motor units after extensive peripheral nerve injuries // Journal of Neurophysiology. 1996; 75 (1): 268-81. https://doi.org/10.1152/jn.19184.108.40.2068
29. Shefner J. Motor unit number estimation in human neurological diseases and animal models // Clinical Neurophysiology. 2001; 112 (6): 955-64. https://doi.org/10.1016/s1388-2457(01)00520-x
30. Udina E, Ceballos D, Gold B, Navarro X. FK506 enhances reinnervation by regeneration and by collateral sprouting of peripheral nerve fibers // Experimental Neurology. 2003; 183 (1): 220-31. https://doi.org/10.1016/s0014-4886(03)00173-0
This work is licensed under a Creative Commons Attribution 4.0 International License.