New Method of Injured Nerve Repair
14 November 2016
05 April 2017
14 July 2017 (online)
Background Innovative surgical techniques form the basis of therapeutic approaches to address the negative consequences of nerve damage. This study evaluated the effectiveness of nerve trunk regeneration after the use of an electrosurgical instrument by looking at the patterns of morphological changes in the injured nerve and the structural elements of the segment motor center.
Methodology The study was performed on male Wistar rats divided into four groups: group 1, control; group 2, rats with simulated sciatic nerve injury with epineural sutures; 3, rats subjected to an experimental surgical procedure using high-frequency electric welding technology; and 4, rats with simulated sciatic nerve injury without posttransection repair. To study changes in the peripheral stump of the transected nerves and L5 segments of the spinal cord, we used histologic, immunohistochemical, and morphometric methods.
Results At week 12 after the surgery, there were more S-100+ Schwann cells, increased expression of neurofilaments (NFs), and glial fibrillary acidic protein in the peripheral stump in group 3 than in groups 2 and 4, which indicates enhanced neurotization and myelination. Group 3 animals demonstrated reduced expression of S-100 and NFs in the motor center of the spinal cord compared with group 2 that suggests less pronounced reactive changes caused by electric welding technology.
Conclusions The study showed a novel surgical method using an electrosurgical instrument in a welding mode to stimulate regeneration of the injured nerve and to cause less prominent reactive changes in its segment motor center.
- 1 Bekelis K, Missios S, Spinner RJ. Falls and peripheral nerve injuries: an age-dependent relationship. J Neurosurg 2015; 123 (05) 1223-1229
- 2 Castillo-Galván ML, Martínez-Ruiz FM, de la Garza-Castro O, Elizondo-Omaña RE, Guzmán-López S. Study of peripheral nerve injury in trauma patients [in Spanish]. Gac Med Mex 2014; 150 (06) 527-532
- 3 Missios S, Bekelis K, Spinner RJ. Traumatic peripheral nerve injuries in children: epidemiology and socioeconomics. J Neurosurg Pediatr 2014; 14 (06) 688-694
- 4 Dahlin LB. Techniques of peripheral nerve repair. Scand J Surg 2008; 97 (04) 310-316
- 5 Menovsky T, Beek JF. Laser, fibrin glue, or suture repair of peripheral nerves: a comparative functional, histological, and morphometric study in the rat sciatic nerve. J Neurosurg 2001; 95 (04) 694-699
- 6 Korsak AV, Chaikovskii YB. Immunohistochemical analysis of the structure of injured peripheral nerve neuroma after electrosurgical welding intervention. Bull Exp Biol Med 2015; 159 (06) 789-791
- 7 Hwang K, Kim SG, Kim DJ. Hypoglossal-facial nerve anastomosis in the rabbits using laser welding. Ann Plast Surg 2008; 61 (04) 452-456
- 8 Tse R, Ko JH. Nerve glue for upper extremity reconstruction. Hand Clin 2012; 28 (04) 529-540
- 9 Sameem M, Wood TJ, Bain JR. A systematic review on the use of fibrin glue for peripheral nerve repair. Plast Reconstr Surg 2011; 127 (06) 2381-2390
- 10 Hunt TR, Wiesel SW. Operative Techniques in Hand, Wrist, and Forearm Surgery. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2011
- 11 Linchevskyy O, Makarov A, Getman V. Lung sealing using the tissue-welding technology in spontaneous pneumothorax. Eur J Cardiothorac Surg 2010; 37 (05) 1126-1128
- 12 Echeverry S, Shi XQ, Zhang J. Characterization of cell proliferation in rat spinal cord following peripheral nerve injury and the relationship with neuropathic pain. Pain 2008; 135 (1-2): 37-47
- 13 Liu N, Zang KK, Zhang YQ. Activation of microglia and astrocytes in different spinal segments after peripheral nerve injury in mice [in Chinese]. Sheng Li Xue Bao 2015; 67 (06) 571-582
- 14 Zhu Q, Couillard-Després S, Julien JP. Delayed maturation of regenerating myelinated axons in mice lacking neurofilaments. Exp Neurol 1997; 148 (01) 299-316
- 15 Korsak A, Chaikovsky Y, Sokurenko L, Likhodiievskyi V, Neverovskyi A. Reactive changes in spinal cord motoneurons after sciatic nerve injury after high-frequency electrosurgical instrument application [in Russian]. Georgian Med News 2016; (251) 77-83