Morphometric and functional results after CO(2) laser welding of nerve coaptations.
OBJECTIVE
Several reports describe nerve coaptations by laser welding in combination with stay sutures and bonding material. This study was undertaken to obtain functional and morphologic information by using a nerve coaptation technique by epineurial CO(2) laser welding only.


METHODS
The sciatic nerves of 24 rats were transected and epineurially coapted with the CO(2) laser at 60 mW or with microsutures as a control. Walking track analysis were carried out to evaluate the functional recovery, and the nerves were harvested for histology after 6 months of regeneration.


RESULTS
None of the 24 nerves showed dehiscence of the coaptations, and all showed good nerve fiber regeneration. Better results were obtained for the functional evaluation of the sciatic function index (P < 0.02) and the toe spread index (P < 0.04) from the laser nerve coaptations. Likewise, the morphologic evaluations of the fiber density (P < 0.04) and area fraction (P < 0.002) were better in the laser group.


CONCLUSIONS
CO(2) laser welded nerve coaptations are as successful as their sutured counterparts and may become a promising alternative in clinical practice.
Happak
W
W
Division of Plastic and Reconstructive Surgery, Department of Surgery, Medical School, University of Vienna, Vienna, Austria. wolfgang.happak@akh-wien.ac.at
Neumayer
C
C
Holak
G
G
Kuzbari
R
R
Burggasser
G
G
Gruber
H
H
D000818:Animals; D002245:Carbon Dioxide; D017075:Laser Coagulation / Q000295:instrumentation / Q000379:methods*; D009412:Nerve Fibers / Q000528:radiation effects; D009416:Nerve Regeneration / Q000528:radiation effects*; D051381:Rats; D017207:Rats, Sprague-Dawley; D020127:Recovery of Function; D012584:Sciatic Nerve / Q000293:injuries / Q000473:pathology / Q000503:physiopathology / Q000528:radiation effects*; D013537:Sutures; D016138:Walking; D014945:Wound Healing / Q000528:radiation effects*; D014947:Wounds and Injuries / Q000503:physiopathology / Q000601:surgery*
D002245:Carbon Dioxide