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C3 Toxin and Poly-DL-Lactide-ε-Caprolactone Conduits in the Critically Damaged Peripheral Nervous System

A Combined Therapeutic Approach

Leibig, Nico MD*; Boyle, Veronika MD; Kraus, Daniel MD; Stark, Gerhard Bjoern MD; Penna, Vincenzo MD

doi: 10.1097/SAP.0000000000000415
Peripheral Nerve Surgery and Research

Introduction Peripheral nerve regeneration over longer distances through conduits is limited. In the presented study, critical size nerve gap bridging with a poly-DL-lactide-ε-caprolactone (PLC) conduit was combined with application of C3 toxin to facilitate axonal sprouting.

Materials and Methods The PLC filled with fibrin (n = 10) and fibrin gel loaded with 1-μg C3-C2I and 2-μg C2II (n = 10) were compared to autologous nerve grafts (n = 10) in a 15-mm sciatic nerve gap lesion model of the rat. Functional and electrophysiological analyses were performed before histological evaluation.

Results Evaluation of motor function and nerve conduction velocity at 16 weeks revealed no differences between the groups. All histological parameters and muscle weight were significantly elevated in nerve graft group. No differences were observed in both PLC groups.

Conclusions The PLCs are permissive for nerve regeneration over a 15-mm defect in rats. Intraluminal application of C3 toxin did not lead to significant enhancement of nerve sprouting.

From the *Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center, Ludwigshafen; †Clinic for Neurology, Ortenau Klinikum Lahr-Ettenheim, Lahr; and ‡Clinic of Plastic and Hand Surgery, University Medical Center Freiburg, Freiburg, Germany.

Received June 11, 2014, and accepted for publication, after revision, November 11, 2014.

Conflicts of interest and sources of funding: none declared.

Reprints: Nico Leibig, MD, Clinic of Hand, Plastic and Reconstructive Surgery, Burn Center, University Heidelberg, Ludwig-Guttmann-Str. 13, 67071 Ludwigshafen, Germany. E-mail:

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