Muscle flap mass preservation with end-to-side neurorrhaphy: an experimental study.
The authors examined the preservation of rat gracilis muscle flap mass after motor and sensory end-to-side neurorrhaphy. The rat gracilis muscle flap model was designed based on a previous study. Twenty-four Sprague-Dawley rats were divided into three groups. In Group 1 (n = 8), the flap was denervated by transecting the obturator nerve. In Group 2 (n = 8), the flap was reinnervated by coapting the proximal saphenous nerve to the distal obturator nerve. In Group 3 (n = 8), the flap was reinnervated by coapting the motor branch of the femoral nerve to the distal stump of the obturator nerve. At 6 months postoperatively, the gracilis muscle flaps were examined, harvested, and weighed individually. Results showed that the flaps with motor nerve reinnervation retained good bulk, with a weight of 634.0 +/- 65.1 gm, which was statistically significantly higher than the denervated group (457.5 +/- 125.3 gm, p < 0.01). However, muscle mass preservation in the sensory reinnervated group (606.9 +/- 209.1 gm) was not significantly different, compared to the denervated group. Histology revealed atrophic changes in the denervated group, compared to the sensory and motor-reinnervated groups. The authors concluded that muscle mass can be preserved by end-to-side nerve repair. Motor nerve reinnervation is able to better arrest atrophic changes of the muscle flaps.
Oswald
Tanya M
TM
Division of Plastic Surgery, University of Mississippi Medical Center, Jackson 39216, USA.
Zhang
Feng
F
Lei
Man-Ping
MP
Gerzenshtein
Jacob
J
Lineaweaver
William C
WC
D000818:Animals; D005267:Femoral Nerve / Q000601:surgery; D009121:Muscle Denervation; D018482:Muscle, Skeletal / Q000294:innervation / Q000473:pathology / Q000601:surgery; D016067:Nerve Transfer; D009776:Obturator Nerve / Q000601:surgery; D051381:Rats; D017207:Rats, Sprague-Dawley; D013524:Surgical Flaps / Q000098:blood supply / Q000294:innervation