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KMID : 0350519920450020573
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Journal of Catholic Medical College
1992 Volume.45 No. 2 p.573 ~ p.585
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The Effect of Degenerated Muscle Graft Entubulated with Fascia on Regeneration of The Sciatic Nerve in Rats
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Abstract
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Recently, it has been observed that the layer of basal lamina surrounding each skeletal muscle fiber enhances regeneration of the axons. Keynes introduced degenerated muscle graft,as an alternate strategy of nerve graft for the peripheral nerve
gap
in
1984, and then extensive studies by Glasby and his coworkers indicated that coaxially aligned, degenerated muscle graft was as effective as nerve graft. But the muscle segments tend to be fragmentary and fragile in process of degeneration, and so
degenerated muscle graft is technically difficult and the grafted segment can be disrupted during healing process.
The aim of this study is to solve these problems and promote the effect of regeneration by grafting the degenerted muscle entubulated with its fascia on the peripheral nerve defect. Forty-five Sdrague-Dawley adult rats were divided into three
groups;
The nerve grafted group(n=15), in which a 10 mm length segment of autogenous nerve was grafted to the 10 mm length nerve defect on the left sciatic nerve, the degenerated muscle grafted group(n=15), in which a 10 mm length segment of degenerated
muscle
treated with freezing and thawing was grafted coaxially tothe nerve defect, and the degenerated muscle and fascia grafted group(n=15), in which a 10mm length segment of degenerated muscle entubulated with its fascia was grafted to the nerve
defect.
The
effects of fascial entubulation of the degenerated muscle were observed and evaluated by gross findings, electrophysiologic examination, and histological examinations at the 60th postoperative day.
@ES The results were as follows.
@EN 1. Sensory and motor functions were optically recovered for 80% in the degenerated muscle and fascia grafted group, 86.7% in the nerve grafted group and 69.2% in the degenerated muscle grafted group.
2. Disruption of the grafts and neuroma formation were develped in 2 cases among the degenerated muscle grafted group.
3. Nerve conduction velocity of the regenerated sciatic nerves in the degenerated muscle and fascia grafted group was 9.91*2.17m/sec and was faster than that of the degenerated muscle grafted group(8.17*1.10m/sec)(P<0.05), but similar to that of
the
nerve grafted grup(10.8*4.14m/sec).
4. Total number of the myelinated axons infiltrated into the grafts in the degenerated muscle and fascia grafted group was 3734.7*320.1 and this number was larger than that of the degenerated muscle grafted group (3026.5*343.1)(P<0.01), but
similar to
that of the nerve grafted group (3680.4*290.8). Total number of the myelinated axons in the distal segments was 1821.7*187.1 for the degenerated muscle and fascia grafted group, 1798.1*177.3 for the nerve grafted group and 1635.7*191.7 for the
degenerated muscle grafted group.
The results form this experiment suggest that degenerated muscle graft entubulated with its fascia would promote axonal regeneration more than degenerated muscle graft only, and this method is easier to maintain the graft during and after the
operation.
We suggest that this improved method of degenerated muscle graft could bo of use in the repair of human peripheral nerve injuries.
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KEYWORD
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