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Tissue Engineered Guided Regenerative Gel for Recovery of Peripheral Nerve Injury with Massive Loss Defect
Shimon Rochkind, MD; Moshe Graif; Zvi Nevo, PhD
Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
Background: Guided Regeneration Gel (GRG) was developed to simulate the extracellular milieu, support growth and activity of axons and cells in vitro and in vivo upon implantation, as well as destined to serve as a regenerative and repair source for nerve tissue reconstruction.
Purpose: Evaluation of the efficacy of GRG based on tissue-engineering technology for the treatment of complete peripheral nerve injury with significant loss defect.
Methods: Rat sciatic nerve was completely transected and a 2cm segment of the peripheral nerve was removed. Composite transplant, containing a guiding tube filled with GRG, which is an excellent milieu for growth of axons, was placed between the proximal and the distal parts of the transected nerve for reconnection of 2cm long distance.
Results: The post-operative follow-up (up to 4 months) of the operated rats showed re-establishment of active foot movements. The tube had dissolved and the nerve showed complete reconnection. Histological observation of the nerve showed growth of myelinated axons in the place where nerve defect was replaced by composite nerve transplant, and continuation of axonal sprouting through the place of the tube to the distal part of the nerve.
Conclusion: Utilization of an innovative composite implant to bridge a gap resulting from removal of a 2cm peripheral nerve segment shows promise, suggesting the feasibility of this approach for reconstruction of peripheral nerve lesions. Such an implant may serve as a vital bridging station in peripheral nerve injuries with massive loss of tissue.
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