Positive Effect of Wrapping with Nerve Conduit on Nerve Recovery After Peripheral Nerve Suturing.

Abstract

Complete recovery after end-to-end peripheral nerve suturing remains challenging due to perineural scarring. We developed a biodegradable nerve conduit composed of poly L-lactide (PLA) and poly ε-caprolactone (PCL) to prevent adhesion and promote nerve regeneration. This study assessed whether wrapping a sutured nerve with this conduit could reduce adhesion and enhance recovery in a rat model. Thirty-six rats underwent sciatic nerve transection, suturing, and adhesion induction, then were assigned to a control group (no wrapping) or a wrapping group (PLA/PCL conduit). At 12 weeks, functional recovery was assessed using the von Frey test, sciatic functional index, and gastrocnemius muscle weight. Electrophysiological assessments included compound muscle action potential (CMAP) amplitude and nerve conduction velocity (NCV). Histological analyses evaluated axonal regeneration, perineural scarring, and fascicular morphology with immunostaining and Masson's trichrome staining. Fascicular circularity was analyzed for correlation with electrophysiological outcomes. The wrapping group showed significantly better sensory and motor recovery, with higher CMAP amplitude and NCV on electrophysiological assessments. Histological examination revealed enhanced axonal regeneration, reduced perineural scarring, and preservation of fascicular circularity. Fascicular circularity was positively correlated with electrophysiological performance. The PLA/PCL conduit effectively minimized perineural scar adhesion and nerve compression while promoting nerve regeneration and functional recovery during the first 12 weeks. Its tubular structure maintained integrity, preventing scar invasion and preserving funicular morphology. Although these findings highlight the short-term potential of the PLA/PCL conduit for peripheral nerve repair, further studies are warranted to evaluate its long-term safety and efficacy beyond the early postoperative phase. Wrapping a repaired peripheral nerve with a biodegradable PLA/PCL conduit provides postoperative protection, minimizes scar adhesion, and supports nerve regeneration for 12 weeks. This technique could serve as an effective strategy to enhance functional recovery by promoting optimal nerve healing.