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Abstract
Purpose
To investigate the effectiveness and to compare the degree of axonal regeneration with the control after the topical application of dexamethasone, hyaluronic acid and amniotic fluid at the repair site of the peripheral nerve.
Materials and Methods
The left sciatic nerves of 40 adult Sprague-Dawley rats were transected and neurorrhaphy was performed. The nerves were divided into four groups according to the solution applied around the repair site: control group (group 1), 0.3 ml normal saline: experimental groups, 0.3 ml dexamethasone (group 2), 0.3 ml hyaluronic acid (group 3), and 0.3 ml amniotic fluid (group 4). The thickness of the perineural scar tissue, the count of the myelinated nerve fiber and axonal regeneration on the repair site were evaluated electromyographically and histologically 4 and 12 weeks after surgery.
Results
The peak amplitude of the compound motor action potential was observed in group 2, at postoperative 4 weeks and group 3 at postoperative 12 weeks. The increase in the number of myelinated nerve fibers was most prominently in group 3 at 4 and 12 weeks after surgery. The degree of perineural scarring was lowest in group 2 at postoperative 4 weeks and in group 3 at postoperative 12 weeks.
Figures and Tables
Fig. 3
The mean peak amplitude between each groups 4 and 12 weeks after surgery. The mean peak amplitude was highest in Group 2 4 weeks after surgery and 12 weeks after surgery in Group 3. The data is reported as the mean±SD.
Fig. 4
(A) There are a few myelinated nerve fibers and unmyelinated nerve fibers (black arrow) in group 1 4 weeks after surgery (TEM, ×5,000). (B) There are many myelinated nerve fibers (black arrow) 4 weeks (TEM, ×5,000) after surgery in group 3.
Fig. 5
(A) A few myelinated nerve fibers and unmyelinated nerve fibers were observed 12 weeks (TEM, ×5,000) after surgery in group 1. (B) Increased number of myelinated nerve fibers and unmyelinated nerve fibers is 12 weeks (TEM, ×5,000) after surgery in group 3.
Fig. 6
The mean axonal count among each group in 4 and 12 weeks after surgery. The data is reported as the mean±SD.
Fig. 7
Longitudinal sections of the sciatic nerves taken at the repair site 4 weeks after surgery. (A) Nerve applied with saline (group 1) showing a dense band of connective scar tissue surrounding the nerve (toluidine blue, LM, ×400). (B) Nerve applied with dexamethasone (group 2) showing a thin layer of epineural scar tissue (toluidine blue, LM, ×400).
Fig. 8
Longitudinal sections of the sciatic nerves taken at the repair site 12 weeks after surgery. (A) Nerve applied with saline (group 1) showing an increase in connective scar tissue surrounding the nerve (toluidine blue, LM, ×400). (B) Nerve applied with HA (group 3) showing significantly less epineural scar tissue (toluidine blue, LM, ×400).
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