REDUCTION OF EXTRANEURAL SCARRING BY ADCON-T N AFTER SURGICAL INTERVENTION/

THE EFFECTS OF ADCON-T/N (Gliatech, Inc., Cleveland, OH), a carbohydra te polymer gel, on peripheral nerve scarring and regeneration were stu died in rodents undergoing three types of surgical intervention. Proce dure I involved external neurolysis of the sciatic nerve from surround ing tissues and separation of its tibial and peroneal components. Proc edure II involved the addition of an abrasive injury. Procedure III in volved transection and suture anastomosis of the tibial component. ADC ON-T/N or a control gel was locally applied in a blind fashion. Additi onal animals received no gel, as a further control. Animals underwent second operations 4 weeks after Procedures I and II and 6 weeks after Procedure III. The surgical sites were evaluated using a numerical gra ding scheme to assess wound healing, sciatic nerve adherence to surrou nding tissues, and separability of its tibial and peroneal components. Animals receiving ADCON-T/N demonstrated reduced nerve adherence to s urrounding tissues and enhanced separability of the tibial and peronea l components, compared with animals receiving control gel or no gel. Q uantitative histological analysis revealed a statistically significant reduction in the amount of dense scar tissue surrounding nerves treat ed with ADCON-T/N. No evidence of nerve toxicity caused by ADCON-T/N w as noted. Counts of regenerating myelinated axons in animals undergoin g nerve transection and suture repair did not statistically differ in treated and untreated animals. In conclusion, ADCON-T/N seems to be bo th safe and effective in reducing extraneural scar formation after per ipheral nerve surgery and local trauma.