Abstract
The repair of wide gaps in peripheral nerve injuries is the vexing problem. For this purpose many attempts have been made in the past by nerve homografts with no success. It is most important to reduce a immune foreign body reaction in nerve homografting. Marmor reported irradiated nerve homografting with success in dogs. Our Co60 irradiated homografting summarised as below.
Thirty adult rabbits were used in this study. The tibial nerve grafts were excised and frozen immediately by dry ice, and stored at -20°C until irradiation. The grafts were irradiated by Co60 with 200×104 roentgen equivalent physicals in a frozen state and stored in a freezer.
A two centimeter irradiated nerve was implanted intramuscularly. At one week after operation, non-irradiated implant was involved in a inflammatory cellular reaction, but no reaction about the irradiated one was observed. At two or three weeks there was no reaction around the irradiated implant. By contrast, marked fibrous tissue proliferation and destruction were observed about non-irradiated one.
The irradiated nerve homografts were implanted between a gap of 3.5-4 centimeters of the tibial nerve. The grafts were sutured through the nerve sheath. Electromyograms showed Fibrillation Voltage at 1st or 2nd week after operation, low complex NMU Voltage at 15th week, normal NMU Voltage or High Amplitude NMU Voltage at 20th week in the case of good recovery. But in this case Fibrillation Voltage was observed in some area. Each graft was explored surgically. The Bodian strain was employed. Schwann cells proliferation about the plant and axis cylinder were visible. No cellular infiltration had occurred.
