SYNTHETIC NERVE GRAFT CONTAINING COLLAGEN AND SYNTHETIC SCHWANN-CELLSIMPROVES FUNCTIONAL, ELECTROPHYSIOLOGICAL, AND HISTOLOGICAL PARAMETERS OF PERIPHERAL-NERVE REGENERATION

Current methods of peripheral nerve repair are to directly suture cut nerve stumps, or to bridge large gaps with an autograft repair. Autogr aft-associated problems include donor site morbidity and limited suppl y. Many of the present limitations of nerve repair might be overcome b y expanding the patients own Schwann cells in vitro, then combining th e cells with other neuro-tropic and -trophic materials into an Artific ial Nerve Graft (ANG) for bridging a nerve gap. In this 4.5 month expe riment, a rat peroneal nerve model with a 10 mm gap was used to evalua te the effect of live Schwann cells on peripheral nerve regeneration. Nerve gaps were repaired with cellular ANGs containing live Schwann ce ll, dead Schwann cell, or mixed fibroblast/Schwann cell populations su spended in a collagen I matrix, and with sutured autografts or ANGs co ntaining just collagen or medium. Regenerated nerves were evaluated by walking track analysis, qualitative and quantitative histology, and e lectrophysiology. Overall, the autograft was the best repair method, w hile the ANG containing live Schwann cells was statistically superior to other ANG repair methods. This study demonstrates that an ANG conta ining cultured syngeneic Schwann cells improves functional, histologic al, and electrophysiological parameters of peripheral nerve regenerati on.