Stromal vascular fraction combined with silicone rubber chamber improves sciatic nerve regeneration in diabetes.

PURPOSE: To study the effects of transplantation of characterized uncultured stromal vascular fraction (SVF) on sciatic nerve regeneration. METHODS: A 10-mm sciatic nerve defect was bridged using a silicone conduit filled with SVF. In control group, silicone conduit was filled with phosphate-buffered saline alone. In sham-operated group, the sciatic nerve was only exposed and manipulated. The regenerated nerve fibers were studied 8 and 12 weeks after surgery. RESULTS: Behavioral and functional studies confirmed faster recovery of regenerated axons in SVF transplanted animals than in control group (p<0.05). Gastrocnemius muscle mass in SVF transplanted animal was found to be significantly more than that in control group. Morphometric indices of the regenerated fibers showed the number and diameter of the myelinated fibers to be significantly higher in SVF transplanted animals than in control group. In immunohistochemistry, the location of reactions to S- 100 in SVF transplanted animals was clearly more positive than that in control group. CONCLUSION: SVF transplantation combined with silicone conduit could be considered as a readily accessible source of stromal cells that improves functional recovery of sciatic nerve. It may have clinical implications for the surgical management of acute diabetic patients after facial nerve transection.

Improvement of peripheral nerve defects using a silicone conduit filled with hepatocyte growth factor.

OBJECTIVE: To assess local effects of hepatocyte growth factor (HGF) on peripheral nerve repair in a rat sciatic nerve transection model. STUDY DESIGN: Sixty male, healthy, white Wistar rats were randomized into 4 experimental groups: In the sham-operated group, sciatic nerve was exposed and manipulated. In the transected control group, the left sciatic nerve was transected. In the silicone graft group (SIL), a 10-mm defect was made and bridged using a silicone tube. The graft was filled with phosphate-buffered saline in the SIL group and with HGF in the SIL/HGF group. RESULTS: Behavioral testing, sciatic nerve functional study, gastrocnemius muscle mass measurement, and morphometric indices found earlier regeneration of axons in the SIL/HGF than in the SIL group (P < .05). Immunohistochemical study clearly found more positive location of reactions to S-100 in the SIL/HGF group than in the SIL group. CONCLUSIONS: HGF may have clinical implications for the surgical management of patients after facial nerve transection.