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Validation of Nerve Tape in single strand graft repairs in a rabbit model
Geetanjali Bendale, PhD
1, Marc Mazur, MD
1, Taylor Allen, BS
1, Peter Lamothe, MS
1, Ananya Gomatam, BS
1, Hope Richard, MD
1; Jonathan Isaacs, MD
2(1)Virginia Commonwealth University, Richmond, VA, (2)Department of Orthopaedics, Virginia Commonwealth University, Richmond, VA
Introduction: Peripheral nerve gaps that cannot be directly coapted require graft bridging . Conventional microsuture-based repairs are time-intensive, technically demanding, and lead to inconsistent alignment and often suboptimal outcomes. Nerve Tape, an FDA-approved device for primary repair of non-gap nerve injuries, offers a sutureless, microhook-based alternative. While Nerve Tape's utility in end-to-end repairs has been established, a potential role in facilitating nerve grafting has not been demonstrated.
Materials and Methods: Twenty 5-month old female New Zealand White rabbits were utilized in this study. The left sciatic nerves were exposure and the tibial nerves isolated. A 30 mm segment of the tibial nerve was excised, reversed, and re-inset as an autograft. Animals were assigned to one of two groups; 1)Suture Group (n=10): Graft inset using four 9-0 nylon epineural sutures at each co-aptation and 2)Nerve Tape Group (n=10): Graft inset using two Nerve Tape devices applied at both proximal and distal coaptations. At 4 months post-repair, functional outcomes were assessed using electrophysiology and gastrocnemius muscle mass and girth as a ratio of the healthy control muscle. During explantation, both proximal and distal co-aptations and the mid-graft locations were scored for adhesion/scar tissue. Nerve segments proximal, distal and from within the graft were assessed for axon morphometry (axon counts, g-ratio)using toluidine blue and semi-quantitative analysis of scarring/inflammation using H&E staining.
Results: At 4-months post-surgery, adhesion scoring showed that at both proximal and distal co-aptation sites, the microsuture group (3.8±0.4 and 3.7±0.5) had significantly higher scar scores as compared to the Nerve Tape group(2.3±0.4 and 2.5±0.5). At the mid-graft, scar tissue scores were similar between the two groups(3.3±0.5 for microsutures and 2.5±0.6 for Nerve Tape). Average normalized muscle mass and muscle girth for micro-suture group was 63.9±13.6% and 82.5±9.8% and Nerve Tape group was 63.1±11% and 83.3±0.4, with no statistically significant differences. Axon morphometry, electrophysiology, and H&E data are pending analysis.
Conclusion: This study demonstrates the feasibility of using Nerve Tape for graft-based nerve repair and has the potential to establish Nerve Tape as a reliable, efficient alternative to microsutures in autograft or allograft insetting.
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