Study on early frozen section after nerve repair with "cell surgery" technique.
OBJECTIVE: To observe the early histological change at the nerve anastomotic sites after using "cell surgery" with conventional microsuture. METHODS: Twenty-two Sprague Dawley rats were divided into three groups: the first group as the control group n=6. The left sciatic nerves were cut using conventional cut method and repaired by either two (n=2) or four (n=4) epineurial stitches of 11-0 monofilament nylon. In the second group of rats, all the experimental procedures were undertaken freezingly and trimingly with a razor blade using sawing movements (n=4) or guillotine-like movements (n=4). The nerve stumps were then brought into apposition and aligned after thawing. A drop of fibrin glue was spread over each of the sites of anastomosis under an operating microscope. For the third group of 8 rats, all the procedures were similar to those of the second group except that glue welding was done after thawing. RESULTS: After the frozen nerves were cut and thawed, the alignment of the disorganized axon became much better at anastomotic sites after fibrin glue welding. Histological sections found that the axonal alignment was good, especially at the central part of the anastomotic sites except a slight disorganization of the peripheral part. The method of glue coaptation before thawing seems to be a better method than that after thawing. CONCLUSIONS: "Cell surgery" technique can improve the nerve repair at the astomotic sites. When we weld the nerve with fibrin glue, coaptation before thawing should be achieved soon.
Zhang
Changqing
C
The Hand Surgery Department of Huashan Hospital, Shanghai Medical University, Shanghai 200040, China.
Gu
Yudong
Y
Chen
Liang
L