Positive Effect of Wrapping with Nerve Conduit on Nerve Recovery after Peripheral Nerve Suturing

BACKGROUND: Complete recovery after end-to-end peripheral nerve suturing remains challenging due to perineural scarring. The authors developed a biodegradable nerve conduit composed of polylactide (PLA) and polycaprolactone (PCL) to prevent adhesion and promote nerve regeneration. This study assessed whether wrapping a sutured nerve with this conduit could reduce adhesion and enhance recovery in a rat model. METHODS: Thirty-six rats underwent sciatic nerve transection, suturing, and adhesion induction, and were assigned to a control group (no wrapping) or a wrapping group (PLA/PCL conduit). At 12 weeks, functional recovery was assessed using the von Frey test, sciatic functional index, and gastrocnemius muscle weight. Electrophysiologic assessments included compound muscle action potential amplitude and nerve conduction velocity. Histologic analyses were performed to evaluate axonal regeneration, perineural scarring, and fascicular morphology. Fascicular circularity was analyzed for correlation with electrophysiologic outcomes. RESULTS: The wrapping group showed significantly better sensory and motor recovery, with higher compound muscle action potential amplitude and nerve conduction velocity. Histologic examination revealed enhanced axonal regeneration, reduced perineural scarring, and preservation of fascicular circularity. Fascicular circularity was positively correlated with electrophysiologic performance. CONCLUSIONS: The PLA/PCL conduit effectively minimized perineural scar adhesion and nerve compression while promoting nerve regeneration and functional recovery during the first 12 weeks. Its tubular structure maintained integrity, preventing scar invasion and preserving fascicular morphology. Although these findings highlight the short-term potential of the PLA/PCL conduit for peripheral nerve repair, further studies are warranted to evaluate its long-term safety and efficacy.

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Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.

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