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.