Tiam Mana Saffari

91 REVASCULARIZATION PATTERNS OF NERVE ALLOGRAFTS 5 processing, the nerves were sterilized using g-irradiation and stored in a Sodium Phosphate Buffer (PBS) at 4°C. All steps were carried out at room temperature with agitation under sterile conditions and in laminar flow hood. Surgical procedure Rats were anesthesized in an isoflurane chamber, shaved, prepped and positioned in the nosecone to maintain anesthesia throughout the procedure. Preoperatively, the following were administered subcutaneously: 5 mL of NaCl 0.9% solution (to prevent dehydration), Enrofloxacin (Baytril, Bayer, Germany, 10mg/kg, providing infection profylaxis) and Buprenorphine SR (Buprenorphine SR-LAB, ZooPharm pharmacy, 0.6mg/kg, pain control). During surgery, body temperature was maintained at 37°C with a heating pad. The sciatic nerve on the left side of each rat was fully exposed proximally from the inferior margin of the piriformis muscle to approximately 5 mm distal to the bifurcation, under an operating microscope (Zeiss OpMi 6, Carl Zeiss Surgica, Oberkochen, Germany). A 10-mm segment of the sciatic nerve was excised by sharp transection with microsurgical scissors. In group I, the nerve segment was reversed and placed as an interposition autograft with six 10-0 nylon (10-0 Ethilon, Ethicon Inc., Sommerville, NJ, USA), epineural interrupted sutures on either side of anastomosis. In group II, the nerve gap was bridged with a 10-mm allograft with use of a similar surgical technique. In group III, the gap was also repaired with a 10-mm allograft, but consecutively a pedicled adipofascial flap was wrapped around the nerve allograft. The superficial inferior epigastric artery fascial (SIEF) flap was harvested as previously described 15 . Briefly, a 4-cm paramedian abdominal incision on the ipsilateral side of the nerve reconstruction was made. The femoral artery was identified in the groin, whereafter the superficial inferior epigastric (SIE) vessels were exposed. The 4 x 3 cm SIEF flap containing subcutaneous fat, inguinal fat, the femoral vasculature and SIE vessels, was tunneled subcutaneously toward the nerve reconstruction and wrapped around the nerve. Both the proximal and distal nerve anastomoses were covered with the flap. In all groups, wounds were closed in layers, approximating muscle with two 5-0 absorbable interrupted sutures (5-0 Vicryl Rapide, Ethicon Inc., Sommerville, NJ,