title: Application of two different hemostatic procedures during microsurgical median nerve reconstruction in the rat does not hinder axonal regeneration.
abstract: BACKGROUND
  Hemostatic procedures by means of electrical coagulation or application of topical agents are widely used to avoid postoperative bleeding during microsurgical reconstruction of peripheral nerves. It is speculated, however, that extensive hemostasis could provoke significant nerve damage.
  
  
  OBJECTIVE
  To examine the effects of 2 intraoperative hemostatic procedures on peripheral nerve regeneration.
  
  
  METHODS
  In 36 adult rats divided into 3 groups, the median nerve was transected and repaired by end-to-end neurorrhaphy. During surgery, bleeding was treated in groups 2 and 3 by application of either the topical hemostatic agent Floseal or routine bipolar coagulation. The degree of nerve regeneration was assessed in terms of motor function recovery using weekly grasping test evaluation for 3 months, muscle mass recovery of flexor digitorum sublimis, and stereological assessment of myelinated axon regeneration.
  
  
  RESULTS
  Neither of the 2 applied hemostatic methods induced any negative effects on nerve regeneration as defined by grip strength, muscle mass recovery, and morphology of myelinated nerve fibers. In contrast, Floseal-treated animals showed a faster progression of motor function recovery, and animals subjected to bipolar coagulation revealed a higher muscle mass recovery compared with the control group.
  
  
  CONCLUSIONS
  Controlled application of bipolar coagulation or Floseal does not exert a negative effect on the nerve regeneration outcome in rats. We propose that these methods can be applied safely to patients.
authors.affiliation: Department of Plastic Surgery, Martin-Luther Hospital, Berlin, Germany. Nektarios.sinis@gmail.com
authors.forename: Nektarios
authors.initials: N
authors.lastname: Sinis
authors.forename: Theodora
authors.initials: T
authors.lastname: Manoli
authors.forename: Jennifer Lynn
authors.initials: JL
authors.lastname: Schiefer
authors.forename: Frank
authors.initials: F
authors.lastname: Werdin
authors.forename: Patrick
authors.initials: P
authors.lastname: Jaminet
authors.forename: Armin
authors.initials: A
authors.lastname: Kraus
authors.forename: Michele
authors.initials: M
authors.lastname: Fornaro
authors.forename: Stefania
authors.initials: S
authors.lastname: Raimondo
authors.forename: Stefano
authors.initials: S
authors.lastname: Geuna
authors.forename: Hans-Eberhard
authors.initials: HE
authors.lastname: Schaller
mesh_terms: D000818:Animals; D001369:Axons / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006489:Hemostatic Techniques; D006490:Hemostatics / Q000008:administration & dosage; D008475:Median Nerve / Q000187:drug effects / Q000502:physiology / Q000601:surgery*; D008866:Microsurgery / Q000379:methods*; D009416:Nerve Regeneration / Q000187:drug effects / Q000502:physiology*; D011897:Random Allocation; D051381:Rats; D017208:Rats, Wistar; D019651:Plastic Surgery Procedures / Q000379:methods*
chemical_list: D006490:Hemostatics