Repair of peripheral nerve injury - a novel methodology. A comparison between bonding and suturing of the regeneration ability of a peripheral nerve in adult rat
Publish date: 2001-01-01
Report number: FOI-R--0031--SE
Pages: 20
Written in: Swedish
Abstract
Nerve injuries sustained in war often recover with major functional sequelae despite a modern military surgical treatment which implies that active restoration of nerves in discontinuity does not take place until reconstructive surgery is performed months to years after the time of injury. In modern civilian medical service, nerve injuries are acutely microsurgically sutured, a time consuming technique which, however, can not be applied in wartime were the number of casualties far outnumbers the available surgical resources. Cyanoacrylate, which in biological tissue gives a very rapid and durable adaptation, has since long been used in experimental and clinical surgery, however, not in peripheral nerve reconstruction. The aim of this study is to adapt a cut peripheral nerve using cyanoacrylate and compare the regeneration across the injury site with conventional suturing. The sural nerves were cut bilaterally on adult rats and readapted microsurgically with cyanoacrylate and an epineural suture, respectively. After five to six months of survival the nerves were reexplored and the mean conduction velocity across the former injury site were calculated to 18,6 m/sec for sutured and 20,5 m/sec for glued nerves without the difference to be statistically significant. A light microscopical quantitative morphological analysis showed a comparable number of regenerating myelinated axons between the two adaptation methods. No local foreign body reaction was observed in the cyanoacrylate cases. Since nerve regeneration following cyanoacrylate adaptation is comparable with conventional microsurgical suturing physiologically and morphologically,