[Nerve sutures and nerve grafts for repairing a gap in peripheral nerve injury: an experimental study]. 1995

M Ikeda, and Y Oka
Department of Orthopaedic Surgery, School of Medicine, Tokai University, Kanagawa, Japan.

An experimental study was performed using the canine sciatic nerve in order to compare the efficacies of a vascularized trunk graft (VTG), a free trunk graft (FTG), a vascularized cable graft (VCG), a free cable graft (FCG) and a two stage procedure (TSP) for the repair of a peripheral nerve defect. Both a 4 cm, and a 5 cm nerve defect was repaired using each method, and also a 6 cm defect, using VCG and FCG. After 24 weeks, the intraneural blood flow (IBF) was measured in the 4 cm defect group, and the recovery of nerve regeneration and muscle reinnervation were evaluated by motor nerve conduction velocity, wet muscle weight, and histological examinations of the nerve and the muscles. VTG and VCG both demonstrated superior IBF. The IBF after TSP was less than after VTG and VCG but greater than after FTG and FCG. In the 4 cm defect group, VTG showed the most favorable recovery in both the axonal regeneration and muscle reinnervation and was followed by VCG. Although the recovery after FTG, FCG and TSP appeared to be worse than after VTG and VCG, there was no significant difference. In the 5 cm defect group, VTG showed the most favorable recovery followed by VCG and FCG. For axonal regeneration, FTG was significantly worse than VTG, VCG and FCG. TSP was worst within the 5 cm defect group for muscular reinnervation, although it showed somewhat better axonal regeneration than FTG. In the 6 cm defect group, no significant difference was found between VCG and FCG for the axonal regeneration. Clinically, TSP is used for repairing a short nerve defect just beyond the critical distance that cannot be overcome by a primary end-to-end suture. Nerve grafting, other than FTG, appeared to be the most reliable method of bridging a long nerve defect, and FCG might be the most practical method.

UI MeSH Term Description Entries
D009416 Nerve Regeneration Renewal or physiological repair of damaged nerve tissue. Nerve Tissue Regeneration,Nervous Tissue Regeneration,Neural Tissue Regeneration,Nerve Tissue Regenerations,Nervous Tissue Regenerations,Neural Tissue Regenerations,Regeneration, Nerve,Regeneration, Nerve Tissue,Regeneration, Nervous Tissue,Regeneration, Neural Tissue,Tissue Regeneration, Nerve,Tissue Regeneration, Nervous,Tissue Regeneration, Neural
D009431 Neural Conduction The propagation of the NERVE IMPULSE along the nerve away from the site of an excitation stimulus. Nerve Conduction,Conduction, Nerve,Conduction, Neural,Conductions, Nerve,Conductions, Neural,Nerve Conductions,Neural Conductions
D010525 Peripheral Nerves The nerves outside of the brain and spinal cord, including the autonomic, cranial, and spinal nerves. Peripheral nerves contain non-neuronal cells and connective tissue as well as axons. The connective tissue layers include, from the outside to the inside, the epineurium, the perineurium, and the endoneurium. Endoneurium,Epineurium,Perineurium,Endoneuriums,Epineuriums,Nerve, Peripheral,Nerves, Peripheral,Perineuriums,Peripheral Nerve
D004285 Dogs The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065) Canis familiaris,Dog
D000818 Animals Unicellular or multicellular, heterotrophic organisms, that have sensation and the power of voluntary movement. Under the older five kingdom paradigm, Animalia was one of the kingdoms. Under the modern three domain model, Animalia represents one of the many groups in the domain EUKARYOTA. Animal,Metazoa,Animalia
D013536 Suture Techniques Techniques for securing together the edges of a wound, with loops of thread or similar materials (SUTURES). Suture Technics,Suture Technic,Suture Technique,Technic, Suture,Technics, Suture,Technique, Suture,Techniques, Suture
D059348 Peripheral Nerve Injuries Injuries to the PERIPHERAL NERVES. Peripheral Nerve Injury,Nerve Injuries, Peripheral,Nerve Injury, Peripheral

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