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Nerve Tape is an effective tool for small nerve repair
Geetanjali S Bendale, PhD
1; James Drinane, MD
1; Kush Savsani, BS
1; Raveena Joshi, BS
1; Kenny Phan, BS
1; Jonathan Isaacs, MD
21Virginia Commonwealth University, Richmond, VA; 2Department of Orthopaedics, Virginia Commonwealth University, Richmond, VA
Introduction: While microsuture neurorrhaphy is the gold standard for repairing digital nerves, functional recovery is often sub-optimal due in part to the technical challenges associated with microsurgery. Nerve Tape (NT) is a novel nerve repair device consisting of opposing Nitinol microhook arrays embedded between laminated sheets of processed small intestine submucosa (SIS) and is designed to make nerve repairs easier and more consistent. While its safety and efficacy has been validated in nerves >2mm in diameter, we sought to test the effect of the device on small nerves (1-1.5mm diameter). Nerves in this size range (i.e. digital nerves and small sensory nerves) are actually frequently injured and represent an important segment of the patient population.
Hypothesis: We hypothesize that NT will provide better regeneration and muscle strength recovery as compared to sutures.
Methods: 24 Sprague-Dawley rats underwent sciatic nerve transection and repair with either Nerve Tape, n=12; or microsutures (9-0), n=12. At three months, outcome measures included muscle mass and girth, twitch and tetanic muscle contraction force, and nerve histomorphology. Walking track analysis was used to calculate Sciatic Function Index (SFI) pre-operatively, post-operative day one, and at three months.
Results: At three months post repair, Nerve Tape integrity was maintained for all subjects. No statistical differences were observed in any outcomes following NT versus microsuture repairs. The mean muscle girth and mass following NT repairs were 17.5mm and 2.5g; and 17.9mm and 2.3g following microsuture repairs. The mean supramaximal twitch and tetanic forces of the gastrocnemius muscle following NT repairs were 561.8±88g and 676.88±122g for NT; and 513.39±102g and 704.97±103g following microsuture. The mean SFIs for NT and microsutures preoperatively, one day post-operatively, and at 3 months were 16.7, 52.5, and 48.3 versus 22.6, 90.5 and 23.2 respectively. Axon counts were similar in both suture and nerve tape groups. However, g-ratio was significantly higher in NT group as compared to microsuture group.
Summary: Based on our findings, Nerve Tape appears to offer a similar level of efficacy as conventional microsuturing when applied to small diameter nerve repair
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