Periferik Sinir Kayıplarında Vaskülarize Ven Grefti ile Sinir Onarımı

Abstract

When primary repair is not possible, peripheral nerve losses are treated by grafts. In such cases, repair by nerve grafting is considered as gold standard. In cases of multiple nerve injury or paucity of donor sites, or to decrease the donor site morbidity, alternative grafts are used. The most common of these alternative grafts are vein grafts. In this study, nerve repair is performed by vascularized vein grafts. The study was performed on a total of 24 rats, divided into 4 groups (N=6). A 1 cm defect was made on the right saphenous nerve of the rats. In the sham group, no procedures were performed to repair the defect. The defects of the other groups were repaired by nerve grafts, vein grafts and vascularized vein grafts, respectively. After 3 months, the rats were sacrified; and the samples were macroscopically and microscopically evaluated for nerve regeneration. There was no nerve regeneration in the sham group; newly generated axonal bundles were observed in the other 3 groups. These bundles were well-organized in the nerve graft group, while the bundles of the vein graft and vascularized vein graft groups were observed to be less organized. Schwann cell proliferation and intraneural angiogenesis rates were higher in the vascularized vein graft group. Increase in Schwann cells in the vascularized vein graft group was statistically higher (p<0.05). Considering the long term results, nerve repair by vascularized vein grafting can be used as an alternative to nerve grafts and vein grafts.