J Reconstr Microsurg
DOI: 10.1055/a-2737-5393
Original Article

Efficacy of Nerve Tape-Assisted PEG Fusion in a Rabbit Tibial Nerve Repair Model

Authors

  • Jonathan Isaacs

    1   Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, United States
  • Geetanjali Bendale

    1   Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, United States
  • Charles Reiter

    1   Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, United States
  • Kush Savsani

    1   Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, United States
  • Ananya Gomatam

    2   William & Mary, Williamsburg, Virginia, United States
  • Kenny Phan

    1   Division of Hand Surgery, Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, United States

Funding Information This study was funded by the Department of Defense PRORP grant award #W81XWH-21-1-0825. PEG fusion kits (NTX-001 Kit) were provided by Neuraptive Therapeutics, Inc. (PA).

Abstract

Background

Polyethylene glycol (PEG) hydrogel is capable of fusing transected axons and restoring axonal continuity. The technique requires precise nerve coaptation alignment and stability, which is difficult to achieve utilizing conventional microsuture neurorrhaphy. Nerve Tape (NT) is a microhook-based nerve coaptation device engineered to facilitate stable and accurate nerve end alignment. The primary objective was to modify and validate NT-assisted PEG fusion using a rabbit proximal tibial nerve repair model at an intermediate time point.

Methods

Three groups of rabbits underwent mid-thigh tibial nerve transection and immediate repair with NT + PEG (n = 6), Suture + PEG (n = 6), or Suture only (n = 6). PEG-induced axonal fusion was acutely confirmed via demonstration of compound motor action potential (CMAP) restoration. Final outcome testing at 16 weeks included electrodiagnostic testing, nerve histomorphology, and muscle morphology.

Results

All 18 animals demonstrated immediate restoration of CMAPs. At 16 weeks, there were no statistical differences in nerve conduction velocity or amplitude, no statistical differences between groups in axon counts or g-ratios either near the nerve coaptations or at the ankle, and no differences in normalized gastrocnemius weight or girth.

Conclusion

PEG fusion did not improve nerve regeneration or functional recovery in a rabbit tibial nerve repair model at 16 weeks. Modified NT did not improve the reliability or efficacy of the PEG fusion process compared with microsuture neurorrhaphy.

Note

Portions of paper were presented as a podium presentation at the Military Health Sciences Research Symposium, Kissimmee FL, August 26–29, 2024; poster presentation, 2025 American Society for Peripheral Nerve Annual Meeting, Waikoloa Village, Hawaii, January 17–19, 2025; poster presentation, 2025 IFSSH/IFSHT Triennial Congress, Washington, DC, March 24–28, 2025.




Publication History

Received: 13 May 2025

Accepted: 02 November 2025

Accepted Manuscript online:
05 November 2025

Article published online:
17 November 2025

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