The Role of creating a biological membrane in expediting nerve regeneration for peripheral nerve repairs

Abstract

Nerve guidance channels are natural or synthetic tubular conduits used to bridge the gap between the nerve stumps. Creation of a biological membrane may be a simple and cheaper way to obtain a nerve guidance channel. The goal of this study was to examine the role of a biological membrane in expediting nerve regeneration. Twenty adult male Wistar albino rats weighing 200 to 250 g were divided into two groups equal in number. All the animals underwent median nerve dissection to create a 5-mm gap. In the first group, the defect was repaired with a graft obtained from the contralateral median nerve, while in the second group, a silicon implant was sutured and anastomosed between the stumps. After five weeks, the silicon implant was removed and a nerve graft taken from the contralateral median nerve was anastomosed inside the neoformed biological membrane. Recovery of muscular function indicating nerve regeneration was assessed by the prehension test proposed by Bertelli and Mira. In both groups, measurements were started after five weeks of grafting and continued for 12 weeks. Rats in the second group exhibited an accelerated recovery and nerve regeneration compared to the first group. Nerve regeneration was completed at 10 weeks in the second group, whereas the recovery rate was 90.2% at 12 weeks in the first group (p<0.05). The use of autogenous grafts is still the gold standard in nerve repair. This biological membrane not only expedites nerve regeneration, but also facilitates surgery and reduces operating time because it requires small incisions at the two ends. Considering these advantages, it may prove to be a good alternative to other techniques.