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DOI: 10.1055/s-0029-1215526
The Short- and Long-Term Effects of Seprafilm® on Peripheral Nerves: A Histological and Functional Study
Publication History
Publication Date:
24 April 2009 (online)
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ABSTRACT
Extraneural scar reduction is an important goal in peripheral nerve microsurgery. The use of biosynthetic materials, such as Seprafilm®, reduces postoperative adhesions in abdominopelvic gynecologic and orthopedic surgery. The study evaluates the safety of Seprafilm® in proximity to nerve tissue in a noninjury (phase 1) and injury (phase 2) model. Phase 1 groups were: (1) sciatic nerve exposure and neurolysis (n = 15), (2) Seprafilm® placement superficial to the nerve (n = 15), and (3) circumferentially wrapping Seprafilm® around the nerve (n = 15). Outcome measures at 45 and 90 days included wound inspection, histomorphometry, and stereological analysis of vascularity. Phase II groups were: (1) sciatic nerve cut and repair alone (n = 15) or (2) nerve wrapped with Seprafilm® (n = 15). Nerves were evaluated at 18, 32, and 42 days postoperatively, and animals underwent biweekly functional walking tracks. In phase I, no significant differences were detected between groups. In phase II, fewer perineural scar bands were seen with Seprafilm®. Histomorphometric differences favoring Seprafilm® at 18 days and favoring control at 42 days were noted (p < 0.05), though no differences in functional outcomes were detected. Qualitatively less perineural scar tissue was seen when using Seprafilm®. No functional or histological deleterious effects were noted from placing Seprafilm® on intact nerves or cut and repaired nerves.
KEYWORDS
Seprafilm® - carboxymethycellulose hyaluronate - peripheral nerve - scar reduction - adhesions
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Gregory H BorschelM.D.
Assistant Professor, Division of Plastic and Reconstructive Surgery, Washington School of Medicine, and Department of Biomedical Engineering
660 S. Euclid Ave, Campus Box 8238, St. Louis, MO 63110
Email: borschelg@wudosis.wustl.edu; schlemmerc@wudosis.wustl.edu