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J Reconstr Microsurg 2004; 20(2): 153-157
DOI: 10.1055/s-2004-820772
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA

Combined Application of Human Amniotic Membrane Wrapping and Hyaluronic Acid Injection in Epineurectomized Rat Sciatic Nerve

Güzin Yeşim Özgenel1 , Gülaydan Fílíz2
  • 1Department of Plastic and Reconstructive Surgery, Division of Hand Surgery, Uludağ University Medical School, 16059, Görükle, Bursa, Turkey
  • 2Department of Pathology, Uludağ University Medical School, 16059, Görükle, Bursa, Turkey
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Publication History

Publication Date:
09 March 2004 (online)

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The purpose of this study was to investigate the effects of combined application of human amniotic membrane wrapping and hyaluronic acid injection on peripheral nerve scarring in an adult rat model. After circumferential epineurectomies of right sciatic nerves were performed in each of 72 rats, nerves were randomly divided into three groups: (1) nothing was done additional to epineurectomy; (2) the epineurectomized segment was wrapped with human amniotic membrane; and (3) the epineurectomized segment was wrapped with human amniotic membrane and hyaluronic acid was injected inside. The extent of adhesions and perineurial scar thickness was macroscopically and histologically evaluated at 4 and 12 weeks. The least adhesion and perineurial scar tissue were observed in nerves treated with human amniotic membrane wrapping and hyaluronic acid injection. This combination appears to be safe and effective in preventing perineurial scar formation after peripheral nerve surgery in rats.

KEYWORDS

Hyaluronic acid - human amniotic membrane - peripheral nerve scarring

REFERENCES

  • 1 Karev A, Stahl S. Treatment of painful nerve lesions in the palm by “rerouting” of the digital nerve.  J Hand Surg. 1986;  11A 539-542
    PubMedGoogle Scholar
  • 2 Jupiter J B, Seiler J G, Zienowicz R. Sympathetic maintained pain (causalgia) associated with a demonstrable peripheral nerve lesion. Operative treatment.  J Bone Joint Surg. 1994;  76A 1376-1384
    PubMedGoogle Scholar
  • 3 Haupt W F, Wintzer G, Schop A et al.. Long-term results of carpal tunnel decompression: assessment of 60 cases.  J Hand Surg. 1993;  18B 471-474
    PubMedGoogle Scholar
  • 4 Yu G Z, Firrell J C, Tsai T M. Pre-operative factors and treatment outcome following carpal tunnel release.  J Hand Surg. 1992;  17B 646-650
    PubMedGoogle Scholar
  • 5 Ruch D S, Spinner R M, Koman L A, Challa V R, O'Farrell D, Levin L S. The histologic effect of barrier vein wrapping of peripheral nerves.  J Reconstr Microsurg. 1996;  12 291-295
    PubMedGoogle Scholar
  • 6 Rose E H, Norris M S, Kowalski T A, Lucas A, Flegler E J. Palmaris brevis turnover flap as an adjunct to internal neurolysis of the chronically scarred median nerve in recurrent carpal tunnel syndrome.  J Hand Surg. 1991;  16A 191-201
    PubMedGoogle Scholar
  • 7 Dumanian G A, McClinton M A, Brushart T M. The effects of free fat grafts on the stiffness of the rat sciatic nerve and perineurial scar.  J Hand Surg. 1999;  24A 30-36
    PubMedGoogle Scholar
  • 8 Xu J, Sotereanos D G, Moller A R et al.. Nerve wrapping with vein grafts in a rat model: a safe technique for the treatment of recurrent chronic compressive neuropathy.  J Reconstr Microsurg. 1998;  14 323-328
    Google Scholar
  • 9 Jones N F, Shaw W W, Katz R G. Circumferential wrapping of a flap around a scarred peripheral nerve for salvage of end-stage traction neuritis.  J Hand Surg. 1997;  22A 527-535
    PubMedGoogle Scholar
  • 10 Xu J, Varitimidis S E, Fisher K J, Tomaino M M, Sotereanos D G. The effect of wrapping scarred nerves with autogenous vein graft to treat recurrent chronic nerve compression.  J Hand Surg. 2000;  25A 93-103
    PubMedGoogle Scholar
  • 11 Varitimidis S E, Riano F, Sotereanos D G. Recalcitrant post-surgical neuropathy of the unlar nerve at the elbow: treatment with autogenous saphenous vein wrapping.  J Reconstr Microsurg. 2000;  16 273-277
    Article in Thieme ConnectPubMedGoogle Scholar
  • 12 Petersen J, Russell L, Andrus K et al.. Reduction of extraneural scarring by Adcon-T/N after surgical intervention.  Neurosurgery. 1996;  38 976-984
    CrossrefPubMedGoogle Scholar
  • 13 McLellan D L. Longitudinal sliding of median nerve during hand movements: a contrubitiory factor in entrapment neuropathy.  Lancet. 1975;  1 633-634
    PubMedGoogle Scholar
  • 14 Hunter J H. Recurrent carpal tunnel syndrome, epineurial fibrous fixation, and traction neuropathy.  Hand Clin. 1991;  7 491-504
    PubMedGoogle Scholar
  • 15 Colocho G, Graham W P, Greene A E, Matheson D W, Lynch D. Human amniotic membrane as a physiologic wound dressing.  Arch Surg. 1974;  109 370-373
    PubMedGoogle Scholar
  • 16 Talmi Y P, Finkelstein Y, Zohar Y. Use of human amniotic membrane as a biologic dressing.  Eur J Plast Surg. 1990;  13 160-162
    PubMedGoogle Scholar
  • 17 Azuara-Blanco A, Pillai C T, Dua H S. Amniotic membrane transplantation for ocular surface reconstruction.  Br J Ophthalmol. 1999;  83 399-402
    PubMedGoogle Scholar
  • 18 Tancer M L, Katz M, Veridiano N P. Vaginal epithelialization with human amnion.  Obstet Gynecol. 1979;  54 345-349
    PubMedGoogle Scholar
  • 19 Zohar Y, Talmi Y P, Finkelstein Y, Shvili Y, Sadov R, Laurin N. Use of human amniotic membrane in otolaryngologic practice.  Laryngoscope. 1987;  97 978-980
    PubMedGoogle Scholar
  • 20 Badawy S ZA, Baggish M S, ElBakry M M, Baltoyannis P. Evaluation of tissue healing and adhesion formation after an intraabdominal amniotic membrane graft in the rat.  J Reprod Med. 1989;  34 198-202
    PubMedGoogle Scholar
  • 21 Young R L, Mason B A, Cota J, Wheeler J M, Zund G. The use of an amniotic membrane graft to prevent postoperative adhesions.  Fertil Steril. 1991;  55 624-628
    PubMedGoogle Scholar
  • 22 Bennett N T, Schultz G S. Growth factors and wound healing: biochemical properties of growth factors and their receptors.  Am J Surg. 1993;  165 728-737
    CrossrefPubMedGoogle Scholar
  • 23 Akle C A, Adinolfi M, Welsh K I, Leibowitz S, McColl I. Immunogenicity of human amniotic epithelial cells after transplantation into volunteers.  Lancet. 1981;  7 1003-1005
    PubMedGoogle Scholar
  • 24 Robson M C, Krizek T J. The effect of human amniotic membranes on the bacterial population of infected rat burns.  Ann Surg. 1973;  177 144-149
    PubMedGoogle Scholar
  • 25 Hagberg L, Tengblad A, Gerdin B. Hyaluronic acid in flexor tendon sheath fluid after sheath reconstructions in rabbits.  Scand J Plast Reconstr Hand Surg. 1991;  25 103-107
    PubMedGoogle Scholar
  • 26 Lee H S, Kim J C. Effect of amniotic fluid in corneal sensitivity and nerve regeneration after excimer laser ablation.  Cornea. 1996;  15 517-524
    PubMedGoogle Scholar
  • 27 Amiel D, Ishizue K, Billings E et al.. Hyaluronan in flexor tendon repair.  J Hand Surg. 1989;  14A 837-843
    PubMedGoogle Scholar
  • 28 Hagberg L, Gerdin B. Sodium hyaluronate as an adjunct in adhesion prevention after flexor tendon surgery in rabbits.  J Hand Surg. 1992;  17A 935-941
    PubMedGoogle Scholar
  • 29 Tuncay Y, Özbek H, Atik B, Özen S, Akpinar F. Effects of hyaluronic acid on postoperative adhesion of tendocalcenous surgery: an experimental study in rats.  J Foot Ankle Surg. 2002;  41 104-108
    PubMedGoogle Scholar

Güzin Yeşim ÖzgenelM.D. 

Uludağ Üniversitesi Tip Fakültesi, Plastik ve Rekonstruktif Cerrahi Anabilim Dali

16059 Görükle/Bursa, Turkey

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