At the moment, the results of the plastics of the nerves, and especially with large
defects, often remain unsatisfactory. This work studied the peculiarities of the
process of regeneration after nerve autoplasty under the influenced aspirate bone
marrow and adipose tissue. The experiment was conducted on rabbits (2 series for
25 rabbits). Rabbits were divided into 5 groups: in the first - control group- the nerve
was not damaged, leaving it intact for comparison with normal indices, in the second
group the incision of the nerve segment was carried out in the length of 1 cm, after
which its autoplasty was performed. In the third group, the autoplastics was
supplemented by coating the area with an autologous adipose tissue. In the fourth
group of plastics area was covered by bone marrow aspirate. In 1 and 3 months after
the autoplasty animals were withdrawn from the experiment. Histological,
morphometric and biochemical studies of the nerve fragments in the plastic zone, as
well as the study of the hip and leg muscles, were performed for analysis of the
results. As a result, the positive effect of concentrated bone marrow aspirate and
adipose tissue on the regeneration of the nerve under its plasticity has been proved.
One month after plastics sprouting of axons through the distal suture was observed
only in the group where the bone marrow aspirate was used and its mixture of fatty
tissue. 3 months after nerve plastics in the second group sprouting was observed only
of 49.7 ± 2% axons. While in the group where fat tissue and bone marrow aspirate
were used, the number of axons that sprouted was higher - 67.5 ± 3% and 64.2 ±
2.5% respectively. In the group where a mixture of adipose tissue and bone marrow
aspirate was applied, after 3 months germination of 69.6 ± 3% of axons was
observed. With the use of adipose tissue, the formation of a less dense scar in
epineurium was observed - a protective muffle from adipose tissue was formed around the nerve, which prevented fibrosis of paraneural tissues and prevented from
secondary compression. In the group where the mixture of adipose tissue and bone
marrow was used morphologically, the structure of the paraneural environment most
closely corresponded to a healthy tissue with reproduction of the tissue of slip.
Biochemical indicators indicate a lower degree of ischemia and less pronounced
trophic disturbance of the use of concentrated aspirate of bone marrow and adipose
tissue. In particular, the activity of catalase in 1 month increased in all groups, but
after 3 months in groups where bone marrow aspirate and fatty tissue were used,
these rates were almost normal, while in the control group they were 20% higher
than normal. Significant denervation changes occurred in the control group after 3
months - the area of the muscle fibers was 39 ± 3%, from the intact group, while in
the group where the fatty tissue and bone marrow were applied, it equaled and even
exceeded the level of the intact group. Also, the greater number and area of nuclei in
muscle cells in the groups where fatty tissue was used and the bone marrow aspirate
was significantly higher than the control and intact groups, indicating active
processes of regeneration in the muscles. Also, in groups where bone marrow
aspirate and fatty tissue were used, less pronounced biochemical violations were
observed. The level of lipid peroxidation products (diene conjugates, TBCs of
reactive products and carbonyl groups) in the control group was almost 2 times
higher than normal, while in experimental groups it was significantly closer to
normal. Also, in experimental groups, the activation of enzyme systems - glutathione
peroxidase, glutathione reductase, was observed, indicating a more pronounced
compensatory response compared with the control group. Thus, the use of adipose
tissue and bone marrow aspirates made it possible to improve the results of nerve
plastics and reduce the degree of denervation of muscle disorders. In this study, the
fatty tissue and bone marrow have different mechanisms of action, so the use of their
mixture gives the best result compared to isolated use.
