Tiam M Saffari1, Femke Mathot2, Patricia F Friedrich3, Allen T Bishop3, Alexander Y Shin4. 1. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA; Department of Plastic-, Reconstructive- and Hand Surgery, Erasmus Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. 2. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA; Department of Plastic-, Reconstructive- and Hand Surgery, Radboud University, Houtlaan 4, 6525 XZ Nijmegen, the Netherlands. 3. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA. 4. Department of Orthopedic Surgery, Mayo Clinic, 200 1st St. SW, Rochester, MN 55905, USA. Electronic address: shin.alexander@mayo.edu.
Abstract
INTRODUCTION: The specific patterns of revascularization of allograft nerves after the addition of vascularization remain unknown. The aim of this study was to determine the revascularization patterns of optimized processed allografts (OPA) after surgically induced angiogenesis to the wound bed in a rat sciatic nerve model. MATERIALS AND METHODS: In 51 Lewis rats, sciatic nerve gaps were repaired with (i) autografts, (ii) OPA and (iii) OPA wrapped in a pedicled superficial inferior epigastric artery fascia flap (SIEF) to provide vascularization to the wound bed. At 2, 12, and 16 weeks, the vascular volume and vascular surface area in nerve samples were measured using micro CT and photography. Cross-sectional images were obtained and the number of vessels was quantified in the proximal, mid, and distal sections of the nerve samples. RESULTS: At 2 weeks, the vascular volume of SIEF nerves was comparable to control (P = 0.1). The vascular surface area in SIEF nerves was superior to other groups (P<0.05). At 12 weeks, vascularity in SIEF nerves was significantly higher than allografts (P<0.05) and superior compared to all other groups (P<0.0001) at 16 weeks. SIEF nerves had a significantly increased number of vessels compared to allografts alone in the proximal (P<0.05) and mid-section of the graft (P<0.05). CONCLUSIONS: Addition of surgical angiogenesis to the wound bed greatly improves revascularization. It was demonstrated that revascularization occurs primarily from proximal to distal (proximal inosculation) and not from both ends as previously believed and confirms the theory of centripetal revascularization.
INTRODUCTION: The specific patterns of revascularization of allograft nerves after the addition of vascularization remain unknown. The aim of this study was to determine the revascularization patterns of optimized processed allografts (OPA) after surgically induced angiogenesis to the wound bed in a rat sciatic nerve model. MATERIALS AND METHODS: In 51 Lewis rats, sciatic nerve gaps were repaired with (i) autografts, (ii) OPA and (iii) OPA wrapped in a pedicled superficial inferior epigastric artery fascia flap (SIEF) to provide vascularization to the wound bed. At 2, 12, and 16 weeks, the vascular volume and vascular surface area in nerve samples were measured using micro CT and photography. Cross-sectional images were obtained and the number of vessels was quantified in the proximal, mid, and distal sections of the nerve samples. RESULTS: At 2 weeks, the vascular volume of SIEF nerves was comparable to control (P = 0.1). The vascular surface area in SIEF nerves was superior to other groups (P<0.05). At 12 weeks, vascularity in SIEF nerves was significantly higher than allografts (P<0.05) and superior compared to all other groups (P<0.0001) at 16 weeks. SIEF nerves had a significantly increased number of vessels compared to allografts alone in the proximal (P<0.05) and mid-section of the graft (P<0.05). CONCLUSIONS: Addition of surgical angiogenesis to the wound bed greatly improves revascularization. It was demonstrated that revascularization occurs primarily from proximal to distal (proximal inosculation) and not from both ends as previously believed and confirms the theory of centripetal revascularization.
Authors: T Kangesu; S Manek; G Terenghi; X H Gu; H A Navsaria; J M Polak; C J Green; I M Leigh Journal: Plast Reconstr Surg Date: 1998-04 Impact factor: 4.730
Authors: Caroline A Hundepool; Tim H J Nijhuis; Dimitra Kotsougiani; Patricia F Friedrich; Allen T Bishop; Alexander Y Shin Journal: Neurosurg Focus Date: 2017-03 Impact factor: 4.047
Authors: T M Saffari; F Mathot; R Thaler; A J van Wijnen; A T Bishop; A Y Shin Journal: J Plast Reconstr Aesthet Surg Date: 2020-12-24 Impact factor: 3.022
Authors: Johannes C Heinzel; Viola Oberhauser; Claudia Keibl; Barbara Schädl; Nicole V Swiadek; Gregor Längle; Helen Frick; Cyrill Slezak; Cosima Prahm; Johannes Grillari; Jonas Kolbenschlag; David Hercher Journal: Biomedicines Date: 2022-07-22
Authors: Tiam M Saffari; Femke Mathot; Patricia F Friedrich; Allen T Bishop; Alexander Y Shin Journal: Plast Reconstr Surg Date: 2021-09-01 Impact factor: 4.730