Summary
In this study, a new technique for the repair of divided peripheral nerves using a
flexible controlled-release glass wrap is described and its successful use is reported.
Corglaes is a biodegradable and biocompatible glass which, when used as a solid glass
tube form as a nerve conduit, allows nerve regeneration. It is now produced as a flexible,
porous wrap (CRG-wrap). In this study, the CRG-wrap was used to repair divided median
nerves in the upper forelimb of sheep. The wrap was secured in place around the divided
nerve ends using fibrin glue or 6/0 polyglactin sutures. Microsurgical epineurial
suturing was used to repair the same injury in another group. Twelve sheep were used
in each group. A control group of sheep, on which no operations had been carried out,
was also examined. The outcome of each repair was assessed at 7 months by measuring
transcutaneous stimulated jitter (TSJ), maximum conduction velocity (CVmax), wet muscle
mass and morphometric measurements. Testing was carried out on the limb that had been
operated upon and the normal contralateral forelimb. The ratio of the measurements
taken in the operated and the normal limb (the right and left forelimbs in the control
group) was used when carrying out statistical analyses on the results. The mean and
variance of the ratios of each of the measured variables in the three repair groups
were similar suggesting that nerve regeneration had occurred to a similar degree in
all the repair groups (analyses were carried out using one-way ANOVA and Scheffé's
test, with statistical significance assumed at p<0.05). The repair of peripheral nerves using the CRG-wrap is easy to learn, quicker
and cheaper than microsurgical epineurial suturing, and can be carried out by any
surgeon with basic surgical skills. It was concluded that CRG-wrap is a useful alternative
to microsurgical epineurial suturing for the repair of peripheral nerves.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- The interfascicular nerve-grafting of the median and ulnar nerves.J Bone Joint Surg Br. 1972; 54A: 727-750
- Single fibre electromyography. Studies in healthy and diseased muscle.2nd ed. Raven Press Ltd, 1185 Avenue of the Americas, New York, New York 100361994
- Electrical microstimulation with single fibre electromyography: a useful method to study the physiology of the motor unit.J Clin Neurophysiol. 1992; 9: 105-119
- Jitter measurements by axonal micro-stimulation. Guidelines and technical notes.Electroencephalogr Clin neurphysiol. 1992; 85: 30-37
- Manual of nerve conduction and clinical neurophysiology.3rd ed. Raven Press, New York1994
Kimura J., Electrodiagnosis in diseases of nerve and muscle: principles and practice. 2nd ed. Philadelphia; 2000.
- Stimulated jitter measurement in the assessment of recovery after different methods of peripheral nerve repair.J Hand Surg [Br]. 1998 Feb; 23: 12-16
- Assessment of the method and timing of repair of a brachial plexus traction injury in an animal model for obstetric brachial plexus palsy.J Hand Surg [Br]. 2002 Feb; 27: 13-19
- Stimulated jitter measurements in the assessment of recovery after peripheral nerve repair.J Hand Surg [Br]. 1997 Dec; 22: 772-777
- Follow-up study after replantation of the forearm and nerves resuture.Electromyogr Clin Neurophysiol. 2004; 44: 301-305
- Overall assessment of regeneration in peripheral nerve lesion repair using fibrin glue, suture, or a combination of the 2 techniques in a rat model. Which is the ideal choice?.Surg Neurol. 2005; 64: 10-16
- The prognosis and the change of the maximum conduction velocity of motor fibers in peripheral nerve injuries.Electromyography. 1967 Aug; 7: 177-179
- Facial nerve repair with epineurial suture and anastomosis using fibrin adhesive: an experimental study in the rabbit.J Oral Maxillofac Surg. 2004; 62: 1524-1529
- Changes in muscle cytoarchitecture after peripheral nerve injury and repair. A quantitative and qualitative study.J Hand Surg [Br]. 1998 Jun; 23: 365-369
- Maturation of regenerating nerve fibres with various peripheral connections.J Anat. 1947; 81: 1-23
- Retrograde changes in fibre size following nerve section.J Anat. 1962; 96: 121-129
- Recovery of nerve fibres and diameters in the regeneration of peripheral nerves.J Physiol. 1943; 101: 489-518
- Conduction velocity and myelin thickness in regenerating nerve fibres.J Physiol. 1946; 105: 152-174
- Streptozocin induced diabetes as a model of phrenic neuropathy in rats.J Neurosci Methods. 2006; 151: 131-138
- A new resorbable wrap-around implant as an alternative nerve repair technique.J Hand Surg (British and European Volume). 1999; 24B: 291-295
- Neurorrhaphy.in: Gorio A. Millesi H. Mingrino S. Posttraumatic peripheral nerve regeneration: experimental basis and technique. Raven Press, New York1981: 215-228
Article info
Publication history
Published online: March 12, 2007
Accepted:
June 20,
2006
Received:
February 13,
2006
Footnotes
☆Presented at BAPS Winter meeting 2005.
Identification
Copyright
© 2006 Published by Elsevier Inc.
