Peripheral Nerve Regeneration Across 14-mm Gaps: A Comparison of Autograft and Entubulation Repair Methods in the Rat

ABSTRACT A study was conducted to compare the regeneration across 1.4-cm peroneal nerve gaps in rats, repaired with sutured autografts or with artificial nerve grafts. The artificial models were composed of a biodegradable passive conduit made of glycolide trimethylene carbonate, filled with either phosphate-buffered saline or a collagen extracellular matrix. Functional recovery was evaluated by walking track analysis throughout the experiment. After 9 months, the nerves were analyzed by electrophysiology and by qualitative and quantitative histology. Walking track analysis demonstrated the three repair methods to provide statistically equivalent recovery, except at day 195 post-engraftment, when the collagen-filled conduit was superior to the saline-filled conduit. Electrophysiologically, the autograft was superior to the collagen-filled conduit, while the collagen- and saline-filled conduits were equivalent. Quantitative histology demonstrated that normal intact nerve had larger mean myelinated axonal diameters but an equal number of axons to the three repair methods, and that the repair methods were statistically equivalent. While the repair methods had similar histologic and functional outcomes, combined standardized scoring demonstrated that the autograft was superior to the statistically-equivalent entubulation repairs. A collagen gel may serve as an ideal matrix in which to suspend neurotrop(h)ic factors or cells.