Regeneration of critical injuries of the peripheral nerve with growth factors

• Published in: Revista española de cirugía ortopédica y traumatología 2013-05, Vol.57 (3), p.162-169
• Main Authors: García Medrano, B, Barrio Sanz, P, Simón Pérez, C, León Andrino, A, Garrosa García, M, Martín Ferrero, M A, Gayoso Rodríguez, M J
• Format: Article
• Language: Spanish
• Subjects: Animals; Male; Nerve Regeneration; Peripheral Nerve Injuries - physiopathology; Peripheral Nerves - physiology; Rats; Rats, Wistar
• ISSN: 1988-8856
• DOI: 10.1016/j.recot.2013.03.007

This project aims to study the regeneration of non-repairable lesions of peripheral nerve by muscle grafts enhanced with growth factors. The experiment was carried out in two phases. The first one compared direct suture of a critical defect in the sciatic nerve of ten rats, with the interposition of autologous muscle graft, denatured by heat, in another ten. The second phase compared ten rats with nerve repair using an acellular muscle graft, with injection of 2cc of IGF-1 (10mg/ml mecasermin, Injectable solution) into the acellular graft of another ten. A clinical and functional follow-up was carried out including, ambulation, footprint measurement, and "grasping test". . The animals were sacrificed at 90-100 days, and samples obtained for macro- and microscopic studies with toluidine blue, haematoxylin-eosin and Masson's trichrome staining. The first experiment showed the characteristic findings of nerve tissue in muscle graft level sections. The second was an enhancement of the results: post-surgical clinical improvement, early ambulation, decrease in the rate of pressure ulcers in toes, recovery of the footprint, and increasing the percentage of nerve endings in distal sciatic regeneration (47-62%). In this study the experimental and clinical possibilities of nerve defect repair by denatured muscle are demonstrated, confirming the suitability of the technique. Furthermore, it confirms our hypothesis with clinical and cellular determinations enriched by the addition of growth factors that promote nerve regeneration.