30 July 2019

Innovative approach to repair of severed peripheral nerves

A novel approach for repair of peripheral nerve injuries was the topic of an interesting presentation recently at the Perron Institute.

Dr Zoran Pletikosa, Associate Lecturer in Human Medical Sciences at Western Sydney University (WSU), has developed a repair technique that does away with the need for sutures, using instead a biodegradable collagen membrane wrapped around the nerve and bonded with a photochemically activated dye.

Dr Pletikosa collaborates with Professor Minghao Zheng, head of Brain and Bone Axis research at the Perron Institute.

The standard surgical approach for repair of a transected peripheral nerve involves use of synthetic sutures to re-join the nerve ends. This does not always ensure good alignment of nerve fibre bundles and more importantly leads to retention of permanent non-absorbable suture material, with resultant intraneural foreign body reaction and scarring, and suboptimal functional recovery.

In pre-clinical models, Dr Pletikosa’s technique has demonstrated superior histological and functional recovery when compared to suturing.

He believes that in future it may form a viable and, potentially, better alternative for surgical treatment of nerve injuries in clinical practice. More research will be required, however, to further quantify functional sensory and motor recovery processes, as well as histological changes and outcomes regarding inflammation and regeneration. Additionally, there is potential to apply this technique to repair gap nerve injuries, which is a more realistic scenario in surgical practice. Early pilot studies have shown very encouraging results.

Dr Pletikosa holds a degree in medicine from Croatia where he worked for several years in general practice. He gained firsthand experience of peripheral and central nerve injuries while working as an army physician during the war in former Yugoslavia.

After moving to Australia in 1994 he taught in medical science at various private colleges and universities. After completion of his postgraduate studies in health science education, he was successful in securing a permanent academic position at WSU in 2005.

Dr Pletikosa has since been lecturing in human anatomy and physiology; clinical diagnosis and physical examination methods; clinical neuroscience; pathophysiology; and pharmacology.