Effects of collagen nerve guide on neuroma formation and neuropathic pain

[Guest guest]

Am J Surg. 2007 Jan;193(1):e1-6.

Effects of collagen nerve guide on neuroma formation and neuropathic

pain in a rat model.

Tyner TR, Parks N, Faria S, Simons M, Stapp B, Curtis B, Sian K,

Yamaguchi KT.

Department of Surgery, University Medical Center, University of

California San Francisco-Fresno Medical Education Program, 155 N.

Fresno St., #308, Fresno, CA 93702, USA.

BACKGROUND: Posttraumatic neuroma formation is a major cause of

neuropathic pain that can occur after elective surgery, amputation,

or trauma. This study examined the use of biosynthetic collagen

nerve guides to prevent the development of posttraumatic neuromas.

METHODS: Collagen nerve guides were applied after neurectomy in a

rat sciatic nerve model in an effort to stimulate linear neuronal

outgrowth and reduce random axon sprouting. Animals were monitored

for evidence of neuropathic pain--autotomy scores were recorded for

8 weeks posttransection--after which proximal stumps were excised

and processed for histologic analyses.

RESULTS: Moderate to severe autotomy was observed in 88% (7 of 8) of

the control (neurectomy) animals. In contrast, 13% (1 of 8) of

animals receiving collagen nerve guides developed autotomy, which

was significantly less than controls (P < .01). Qualitative analyses

of neurofilament and Schwann cell-labeled nerve sections showed a

significant enhancement in Schwann cell migration away from the

proximal stump and advanced linear axonal regrowth in the collagen

nerve guide-treated animals.

CONCLUSIONS: Collagen nerve guides alter the regrowth of transected

nerves and reduce the severity of symptoms associated with

neuropathic pain.