Abstract
Repair of root avulsion with suture is not easily accessible due to the narrow surgical field and presence of surgical tension. DuraSeal demonstrated the strong adhesive power without producing the adhesion and neurotoxicity. Herein, we evaluated the possibility of DuraSeal as a substitute in the repair of sciatic nerve gap injury. The nerve gap model was constructed by excising the sciatic nerve (5mm in length) leaving a 5mm nerve defect between the nerve stumps. Animals were categorized into four groups: Group I: no treatment; Group II: 4 stitches suture; Group III: nerve approximation fixed by tissue glue; Group IV: nerve approximation fixed by DuraSeal. The motor function assessment included the CatWalk and SFI as well electrophysiological study. The nerve continuity and regeneration was examined at one and 8 weeks after injury. The inflammatory cells, Schwann cell apoptosis and Schwann cell proliferation were also investigated at one week. The achievement of nerve continuity and myelination by DuraSeal approached that by the suture, as demonstrated by crystal violet and Luxol Fast Blue staining at one and 8 weeks, respectively. The motor function and electrophysiological parameter were restored at DuraSeal and suture group. Early expression of neurofilament and BrdU were also observed in these two groups. There was no statistically significant difference in deposits of macrophage and neutrophil cells or cell apoptosis among these four groups. In conclusion, DuraSeal achieved the same nerve regeneration as compared to that by the suture and produced better regeneration than that by the tissue glue or without any treatment. The accomplishment of nerve regeneration and continuity without causing the neurotoxicity proves the DuraSeal can be used as the ligature in the anastomosis of nerve gap injury.