Painful neuroma formation is a common and debilitating sequela of traumatic or oncologic nerve amputations. Studies suggest that isolating transected nerve stumps within protective caps during amputation surgery or revision procedures may assist in preventing symptomatic nerve-end neuroma formation. This study evaluated the local effects of two porcine small intestine submucosa (pSIS) nerve caps of differing configurations on a terminal nerve end in an animal model. The tibial nerves of 57 Sprague Dawley rats were transected and transposed to the lateral hind leg. The nerves were treated with one of three SIS materials, including (i) a nerve cap with spiraling chambering, termed spiral nerve cap (SNC), (ii) a nerve cap with bifurcated chambers termed chambered nerve cap (CNC), or (iii) an open tube. The surgical control consisted of nerve stumps that were not treated. Overall tissue response, axonal swirling, optical density of axons, and behavioral pain response were quantified at 8 and 12 weeks postoperatively. There were no notable differences between the performance of the SNC and CNC groups. The pSIS nerve caps mitigated aberrant axonal regeneration and decreased neuroma formation and associated pain response. These findings suggest that nerve caps with internal chambers for axonal outgrowth may improve axonal alignment, therefore reducing the likelihood of symptomatic neuroma formation.

中文翻译：

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猪小肠粘膜下神经帽在预防神经瘤和相关疼痛中的应用。

痛苦的神经瘤形成是创伤性或肿瘤性神经截肢的常见且使人衰弱的后遗症。研究表明，在截肢手术或翻修手术过程中隔离保护帽内的横断神经残端可能有助于预防症状性神经末梢神经瘤的形成。这项研究评估了动物模型中两个不同构型的猪小肠粘膜下层（pSIS）神经帽对神经末梢的局部作用。横断57只Sprague Dawley大鼠的胫神经并将其移位至外侧后腿。用三种SIS材料中的一种处理神经，包括（i）带有螺旋腔的神经帽，称为螺旋神经帽（SNC），（ii）带有分叉腔的神经帽，称为腔神经帽（CNC），或（iii ）开管。手术控制包括未经治疗的神经残端。术后8周和12周对整体组织反应，轴突漩涡，轴突光密度和行为疼痛反应进行了定量。SNC和CNC组的性能之间没有显着差异。pSIS神经帽减轻了轴突的异常再生，减少了神经瘤的形成和相关的疼痛反应。这些发现表明，带有轴突生长内腔的神经帽可以改善轴突排列，从而减少症状性神经瘤形成的可能性。pSIS神经帽减轻了轴突的异常再生，减少了神经瘤的形成和相关的疼痛反应。这些发现表明，带有轴突生长内腔的神经帽可以改善轴突排列，从而减少症状性神经瘤形成的可能性。pSIS神经帽减轻了轴突的异常再生，减少了神经瘤的形成和相关的疼痛反应。这些发现表明，带有轴突生长内腔的神经帽可以改善轴突排列，从而减少症状性神经瘤形成的可能性。