Volume 44, Issue 1 e31093

RESEARCH ARTICLE

Non degradation of chitosan and initial degradation of collagen nerve conduits used for protection of nerve coaptations

Susanne Rein MD,

Corresponding Author

Susanne Rein MD

[email protected]

orcid.org/0000-0003-4454-1856

Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Leipzig, Germany

Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany

Correspondence

Susanne Rein, Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Delitzscher Straße 141, 04129 Leipzig, Germany.

Email: [email protected]

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Ralf Schober MD,

Ralf Schober MD

Institute for Pathology and Tumour Diagnostics, Klinikum St. Georg gGmbH, Leipzig, Germany

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Julian Poetschke MD,

Julian Poetschke MD

Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Leipzig, Germany

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Thomas Kremer MD,

Thomas Kremer MD

Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Leipzig, Germany

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Susanne Rein MD,

Corresponding Author

Susanne Rein MD

[email protected]

orcid.org/0000-0003-4454-1856

Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Leipzig, Germany

Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany

Correspondence

Susanne Rein, Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Delitzscher Straße 141, 04129 Leipzig, Germany.

Email: [email protected]

Search for more papers by this author

Ralf Schober MD,

Ralf Schober MD

Institute for Pathology and Tumour Diagnostics, Klinikum St. Georg gGmbH, Leipzig, Germany

Search for more papers by this author

Julian Poetschke MD,

Julian Poetschke MD

Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Leipzig, Germany

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Thomas Kremer MD,

Thomas Kremer MD

Department of Plastic and Handsurgery, Burn Unit, Klinikum St. Georg gGmbH, Leipzig, Germany

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First published: 21 July 2023

https://doi.org/10.1002/micr.31093

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Abstract

Background

Nerve conduits are either used to bridge nerve gaps of up to 3 cm or to protect nerve coaptations. Biodegradable nerve conduits, which are currently commercially available, include Chitosan or collagen-based ones. As histological aspects of their degradation are highly relevant for the progress of neuronal regeneration, the aim of this study was to report the histopathological signs of such nerve conduits, which were removed during revision surgery.

Materials and Methods

Either Chitosan (n = 2) or collagen (n = 2) nerve conduits were implanted after neuroma resection and nerve grafting (n = 2) or traumatic nerve lesion after cut (n = 1) or crush injury (n = 1) in two females and two men, aged between 17 and 57 years. Revision surgery with removal of the nerve conduits was indicated due to persisting neuropathic pain and sensorimotor deficits, limited joint motion, or neurolysis with hardware removal at a median time of 17 months (range: 5.5–48 months). Histopathological analyses of all removed nerve conduits were performed.

Results

A scar neuroma was diagnosed in one out of four patients. Mechanical complication occurred in one patient after nerve conduit implantation bridged over finger joints. Intraoperatively no or only initial signs of degradation of the nerve conduits were observed.

Chitosan conduits revealed largely unchanged shape and structure of chitosan, and coating of the conduit by a vascularized fibrous membrane. The latter contained deposits taken up by macrophages, most likely representing dissolved chitosan.

Characteristic histopathologic features of the degradation of collagen conduits were a disintegration of the compact collagen into separate fine circular strands, No foreign body reaction was observed in all removed nerve conduits.

Conclusions

Both Chitosan nerve conduits have not been degraded. The collagen nerve conduits showed a beginning degradation process. Furthermore, wrapping the repaired nerve with a nerve conduit did neither prevent adhesions nor improved nerve gliding. Therefore, biodegradation in time should be particularly addressed in further developments of nerve conduits.

CONFLICT OF INTEREST STATEMENT

The authors declare that they have no competing interests, except for the fact that Thomas Kremer is an Editorial Board member of Microsurgery and a co-author of this article. To minimize bias, they were excluded from all editorial decision-making as related to this article. The authors disclose any financial conflicts of interest that may influence interpretation of this study and/ or results.

Open Research

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

Supporting Information

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Volume44, Issue1

January 2024

e31093

Non degradation of chitosan and initial degradation of collagen nerve conduits used for protection of nerve coaptations

Abstract

Background

Materials and Methods

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

References

Information

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Non degradation of chitosan and initial degradation of collagen nerve conduits used for protection of nerve coaptations

Abstract

Background

Materials and Methods

Results

Conclusions

CONFLICT OF INTEREST STATEMENT

Open Research

DATA AVAILABILITY STATEMENT

Supporting Information

REFERENCES

References

Related

Information