Preparation of cross-linked carboxymethyl chitosan for repairing sciatic nerve injury in rats.

A successful nerve regeneration process was achieved with nerve repair tubes made up of 1-ethyl-3(3-dimethylaminopropyl) carbodiimide hydrochloride (EDC) cross-linked carboxymethyl chitosan (CM-chitosan) with improved biodegradability. Chitosan has a very slow degradation rate, while the EDC cross-linked CM-chitosan tubes degraded to 30% of original weight during 8 weeks of incubation in lysozyme solution. In vitro cell culture indicated that the CM-chitosan films presented no cytotoxicity to Schwann cells. From in vivo studies using a 10 mm rat sciatic nerve defect model investigated by histomorphometry analysis, the average diameter of the fibers and the average thickness of myelin sheath in the CM-chitosan tubes were 3.7 +/- 0.33 and 0.33 +/- 0.04 mum, respectively, which demonstrated equivalence to nerve autografts (the current "gold" standard); furthermore, the average fiber density in the CM-chitosan tubes was 20.5 x 10(3)/mm(2), which was similar to that of autografts (21 x 10(3)/mm(2)) and significantly higher than that of common chitosan tubes (15.3 x 10(3)/mm(2)).