Nerve Suture Combined With ADSCs Injection Under Real-Time and Dynamic NIR-II Fluorescence Imaging in Peripheral Nerve Regeneration in vivo

Peripheral nerve injury gives rise to devastating conditions including neural dysfunction, unbearable pain and even paralysis. The therapeutic effect of current treatment for peripheral nerve injury is unsatisfactory, resulting in slow nerve regeneration and incomplete recovery of neural function. In this study, nerve suture combined with ADSCs injection was adopted in rat model of sciatic nerve injury. Under real-time visualization of the injected cells with the guidance of NIR-II fluorescence imaging in vivo, a spatio-temporal map displaying cell migration from the proximal injection site (0 day post-injection) of the nerve to the sutured site (7 days post-injection), and then to the distal section (14 days post-injection) was demonstrated. Furthermore, the results of electromyography and mechanical pain threshold indicated nerve regeneration and functional recovery after the combined therapy. Therefore, in the current study, the observed ADSCs migration in vivo, electrophysiological examination results and pathological changes all provided robust evidence for the efficacy of the applied treatment. Our approach of nerve suture combined with ADSCs injection in treating peripheral nerve injury under real-time NIR-II imaging monitoring in vivo added novel insights into the treatment for peripheral nerve injury, thus further enhancing in-depth understanding of peripheral nerve regeneration and the mechanism behind.

Traumatic injuries to the facial nerve: diagnosis and assistance

We performed detection, examination and surgical treatment of trauma injuries of the main trunk or branches of the facial nerve among 16 patients. The main complaints of patients were related to aesthetic defects of tissues and organs within certain areas of the face or the whole half on the side of the injury and their functional disorders. The most frequent cause of injury was yatrogenic nerve damage. In the case of yatrogenic causes of injury, there are following groups of surgical interventions: surgery of the peritoneal salivary gland; aesthetic operations of the face in case of pathological processes or traumatic injuries of the temporal-lower joint and lower zone of the face. The following surgical treatments were used to repair damage to facial nerve structures: nerve suture; transposition of facial nerve branches; neuroplasticity; miofastsialny plasticity; neuroplasty in combination with the transplant of the revascularized neuromuscular transplant of the gentle soapy. In the distant postoperative period, complete recovery of facial nerve branch function and effectors, respectively, occurred among 10 patients. Partial recovery of their function - among 3 patients and recovery were absent among 3 clinical cases.

Entubulation of sciatic nerve of rats with poly-l lactide-co p-lactide

Introduction: Axonal regeneration after a sectioning lesion is variable and depends on the environmental conditions of the two end points. An important enzymatic action and an immune response occur at this point. The Schwann cell at the end of the proximal segment starts a rapid mitotic division in an attemptto locate the target tissue for the severed neuron. The capacity for axonal regeneration after a sectioning lesion is variable and depends on the environmental conditions of the two end points. Objective: To insulate the region of nerve regeneration from biological activities coming from foreign tissues, reducing the immune and enzymatic response and improving the healing conditions of the two end points. Methods: The sciatic nerves of the right paw of twenty WISTAR EPM rats were sectioned, with a gap of 5 to 8mm.In ten animals a 20mm Poly-L Lactide-Co P-Lactide tube involved both sectioned extremities,without nerve suture. After 6 months the animals were sacrificed, the nerve was dissected and photographed. The distal muscles of the paw were sent to histological examination. Results: All animals in which entubulation with Poly-L Lactide- Co P-Lactide was performed demonstrated an excellent nerveregeneration. Histological examination demonstrated complete muscle regeneration. In the animals not submitted to nerve entubulation no nerve regeneration was demonstrated and histological examination demonstrated severe muscle atrophy. Conclusions: Poly-L Lactide-Co P-Lactide entubulationdemonstrated satisfactory nerve regeneration without nerve suture after six months spam. Paw innervated muscles did not show any histological atrophic characteristics.

Clinical Evaluation After Peripheral Nerve Repair With Caprolactone Neurotube

Background: Peripheral nerve injuries with substance loss are challenges to surgeons because direct suture repair may result in malfunction due to nerve suture tension. Autologous nerve grafts are alternatives for treating those lesions; however, harvesting grafts adds morbidity at donor sites. Synthetic substitutes are options to bridge the gaps in these situations. The caprolactone neurotubes are used to assist nerve regeneration, but the literature lacks studies that evaluate their results. Methods: This research was designed to clinically evaluate patients undergoing repair of peripheral nerves with that conduit. We described results of 12 case series consisting of operations with Neurolac®. All nerves severed were sensory and had small gaps (ie, less than 25 mm). Subjective and objective clinical evaluations were performed and registered. Results: Physical examination by monofilament testing and 2-point discrimination showed results rated as good or excellent. However, the patients had complaints regarding sensory changes. Conclusions: Synthetic bioabsorbable guides for nerve repair are promising. The caprolactone conduits were demonstrated to be a safe option treatment and with a simple technique. Although in our study there were some operative complications, they were in line with previous descriptions in the literature. This case series added information about the treatment prognosis, but a higher evidence level study is necessary for decision making.