Redistribution of nerve strain enables end-to-end repair under tension without inhibiting nerve regeneration

作     者：Holly M.Howarth Turki Alaziz Brogan Nicolds Shawn O'Connor Sameer B.Shah 

作者机构：Department of BioengineeringUniversity of California Department of Orthopaedic SurgeryUniversity of California School of Exercise and Nutritional SciencesSan Diego State University Research ServiceVA San Diego Healthcare System 

出 版 物：《Neural Regeneration Research》 (中国神经再生研究（英文版）)

年 卷 期：2019年第14卷第7期

页      面：1280-1288页

核心收录：

学科分类：10[医学] 

基　　金：supported by the Department of Veterans Affairs(VA MERIT IRX001471A to SBS) 

主　　题：tension biomechanics strain end-to-end repair peripheral nerve nerve regeneration 

摘      要：End-to-end repair under no or low tension leads to improved outcomes for transected nerves with short gaps,compared to repairs with a ***,grafts are typically used to enable a tension-free repair for moderate to large gaps,as excessive tension can cause repairs to fail and catastrophically impede *** this study,we tested the hypothesis that unloading the repair interface by redistributing tension away from the site of repair is a safe and feasible strategy for end-to-end repair of larger nerve ***,we tested the hypothesis that such an approach does not adversely affect structural and functional *** this study,we used a rat sciatic nerve injury model to compare the integrity of repair and several regenerative outcomes following end-to-end repairs of nerve gaps of increasing *** addition,we proposed the use of a novel implantable device to safely repair end-to-end repair of larger nerve gaps by redistributing tension away from the repair *** data suggest that redistriubution of tension away from the site of repair enables safe end-to-end repair of larger gap *** addition,structural and functional measures of regeneration were equal or enhanced in nerves repaired under tension – with or without a tension redistribution device – compared to tension-free *** that repair integrity is maintained,end-to-end repairs under tension should be considered as a reasonable surgical *** animal experiments were performed under the approval of the Institutional Animal Care and Use Committee of University of California,San Diego(Protocol S11274).