title: The mesh repair: tension free alternative on dealing with nerve gaps-experimental results.
abstract: We evaluated the feasibility of external epineurial splinting as a way of alleviating tension caused by sutures in the reconstruction of peripheral nerve injuries, utilizing Wistar rat median nerve injury on 40 animals, in four experimental groups with 10 animals on each surgical setting. The nerve regeneration outcomes of four surgical procedures were compared: 1) primary end-to-end sutures (EES); 2) alleviated tension sutures (ATS) with a removal of 7 mm nerve segment, namely external epineurial splinting, utilizing a polypropylene mesh as a protective scaffold; 3) sutures under tension with a 7 mm gap between nerve stumps; and 4) sham (C) (n = 10 animals). Regeneration of the median nerve postneurorrhaphy was followed by means of functional evaluations, including time to first day of finger flexion recovery, and grasp strength; quantification of atrophy of the flexor pronator muscle group; and mRNA expression of nerve growth factor and neurotrophin-3 by polymerase chain reaction-reverse transcriptase. Similar, significant median nerve regeneration was observed in the EES-treated and ATS-treated groups, relative to controls. The EES and ATS surgical procedures methods demonstrated important similar results considering functional and molecular biology analysis of the median nerve injury.
authors.affiliation: Departamento de Clínica Cirúrgica, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Trindade, Florianópolis, SC, Brazil. pkechele@gmail.com
authors.forename: Paulo Roberto
authors.initials: PR
authors.lastname: Kechele
authors.forename: Jayme Augusto
authors.initials: JA
authors.lastname: Bertelli
authors.forename: Eduardo Monguilhotti
authors.initials: EM
authors.lastname: Dalmarco
authors.forename: Tânia Silvia
authors.initials: TS
authors.lastname: Fröde
mesh_terms: D000818:Animals; D005552:Forelimb; D008297:Male; D008475:Median Nerve / Q000293:injuries* / Q000601:surgery*; D018482:Muscle, Skeletal / Q000473:pathology; D020932:Nerve Growth Factor / Q000378:metabolism; D009416:Nerve Regeneration; D019635:Neurosurgical Procedures; D020933:Neurotrophin 3 / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D013526:Surgical Mesh; D013536:Suture Techniques
chemical_list: D020933:Neurotrophin 3; D020932:Nerve Growth Factor