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Hyaluronic acid prevents peripheral nerve adhesion

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1 Hyaluronic acid prevents peripheral nerve adhesion
K. Ikeda, D. Yamauchi, N. Osamura, N. Hagiwara, K. Tomita  British Journal of Plastic Surgery  Volume 56, Issue 4, Pages (June 2003) DOI: /S (03)

2 Fig. 1 Macroscopic findings in the experimental model. (A) In the first stage, the rabbit's sciatic nerve is elevated and the neural bed is coagulated. (B) In the second stage, marked adhesion between the nerve and the neural bed is observed (adhesion group). British Journal of Plastic Surgery  , DOI: ( /S (03) )

3 Fig. 2 The results of the electrophysiological study. The latency of the adhesion group was significantly longer than that of the other groups. The latencies of the HA and steroid groups were significantly shorter than that of the neurolysis group but longer than that of the control group. There was no significant difference between the HA and steroid groups. British Journal of Plastic Surgery  , DOI: ( /S (03) )

4 Fig. 3 Cross-sections through the sciatic nerve and neural bed. The neural bed can be seen at the bottom (Masson's trichrome staining). (A) Neurolysis group: there is fibrous bridging between the nerve and the neural bed; there is no room between the fascicule and the neural bed; and the lower half of the nerve shows intraneural fibrosis. (B) HA group: there is little fibrous bridging between the nerve and the neural bed; and the nerve shows no intraneural fibrosis. (C) Steroid group: there is a little fibrous bridging between the nerve and the neural bed; and the nerve shows no intraneural fibrosis. British Journal of Plastic Surgery  , DOI: ( /S (03) )

5 Fig. 4 The results of the biomechanical study. The tensile strength of the HA group was significantly less than that of the neurolysis group. There was no significant difference between the steroid group and the neurolysis group. British Journal of Plastic Surgery  , DOI: ( /S (03) )

6 Fig. 5 The results of experiment 2. (A) A cross-section through the rat sciatic nerve and neural bed, which has been infiltrated for 5 min with HA. The field is photomicrographed under visible rays without additional staining. The bar indicates 100 μm. The enlarged square is the same as that shown in (B). (B) The enlarged square in (A) was observed under the laser-beam microscope. Fluorescence staining of HA (green) is observed in the epineurium and the surface of the neural bed. British Journal of Plastic Surgery  , DOI: ( /S (03) )


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