Is laser nerve repair comparable to microsuture coaptation?
Efforts to improve functional recovery following nerve injury and repair have included studies of sutureless repairs. The rat sciatic nerve was used as an experimental model to compare the efficacy of laser nerve repairs with standard microsuture repairs. Electrophysiologic (Compound Action Potential), quantitative morphometric, and behavioral (toe spread) measurements were used for assessment, and tensile strength of the repairs was also determined. Electrophysiologic studies showed that microsuture-repaired nerves had significantly faster conduction velocities, but the areas of the waveforms and peak amplitudes showed no significant differences between the two repair groups. Axon counts revealed significant differences in the suture group proximal to the repair site, contrasted with laser repairs. Toe spread evaluations, carried out at three day intervals, demonstrated a significant difference between the two methods of repair in only three out of 22 test dates: in these isolated cases, the suture group measurements were superior. The tensile strength findings confirmed that, at four days, microsuture repair was significantly stronger but thereafter, there was no difference between the two nerve repair techniques.
Maragh
H
H
Microsurgical Research Center, Medical College of Hampton Roads, Norfolk, Virginia.
Hawn
R S
RS
Gould
J D
JD
Terzis
J K
JK
D000200:Action Potentials; D000818:Animals; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D009413:Nerve Fibers, Myelinated / Q000473:pathology / Q000503:physiopathology; D009416:Nerve Regeneration; D011897:Random Allocation; D051381:Rats; D012026:Reflex, Stretch; D012584:Sciatic Nerve / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques; D013718:Tensile Strength