Treatment of Peripheral Nerve Injury with Tension Stitch Method: An Experimental Study

Year 2022, Volume: 12 Issue: 3, 437 - 443, 30.05.2022

Ali Sakinsel Mert Sızmaz Lütfü Baş

https://doi.org/10.16899/jcm.1039032

Abstract

Objective: The aim of our study is to examine the tension stitch method we use to prevent unwanted tissue deficiency between the cut nerve endings in rats that will be kept waiting for secondary neurorrhaphy.
Material and Method: 30 male Wistar Albino rats were randomly divided into three groups. The right sciatic nerve was released proximally from the sciatic nerve 1 \ 3 bifurcation area in the first and second groups and anastomosed with the tibial nerve in the third group. After 4 weeks, the region was reopened, unhealthy nerve endings were cut under the microscope, and secondary neurorrhaphy was performed end-to-end.
Results: In the third experimental group, it was observed that there was no change in the position of the tension stitches placed on the distal and proximal ends of the sciatic nerve, and the nerve endings adhered to the area where they were positioned by suture. At the eighth week, it was observed that the rats that could not use their right lower extremities in the preoperative and early postoperative periods used their extremities more actively. At the twelfth week, it was observed that the rats in all groups had complete recovery of trophic disturbances and the animals started to walk better visually.
Discussion: In our study, the electrophysiological and histopathological data obtained at the eighth week and obtained at the twelfth week were significantly better in the tension-stitched group compared to the other groups, indicating that the best early and late nerve healing was in this group.

Keywords

neurorrhaphy, tension stitch, nerve healing, end-to-end

Gergi Dikişi Yöntemi ile Periferik Sinir Yaralanmalarının Tedavisi: Deneysel Bir Çalışma

Abstract

Amaç: Çalışmamızın amacı sekonder nörorafi için bekletilecek ratlarda kesilen sinir uçları arasındaki istenmeyen doku eksikliğini önlemek için kullandığımız gergi dikiş yöntemini incelemektir.
Gereç ve Yöntem: 30 adet erkek Wistar Albino rat randomize olarak üç gruba ayrıldı. Sağ siyatik sinir, birinci ve ikinci grupta siyatik sinirin 1/3 bifurkasyon alanından proksimalde serbest bırakılırken, üçüncü grupta tibial sinir ile anastomoz yapıldı. Dört hafta sonra bölge yeniden açıldı, mikroskop altında sağlıksız sinir uçları kesildi ve uçtan uca sekonder nörorafi yapıldı.
Bulgular: Üçüncü deney grubunda siyatik sinirin distal ve proksimal uçlarına konulan gergi dikişlerinin pozisyonunda herhangi bir değişiklik olmadığı, sinir uçlarının sütür ile yerleştirildiği bölgeye yapıştığı gözlendi. Sekizinci haftada ameliyat öncesi ve ameliyat sonrası erken dönemde sağ alt ekstremitesini kullanamayan ratların ekstremitelerini daha aktif kullandıkları görüldü. On ikinci haftada tüm gruplardaki ratlarda trofik bozuklukların tamamen düzeldiği ve hayvanların görsel olarak daha iyi yürümeye başladıkları görüldü.
Tartışma: Çalışmamızda sekizinci ve on ikinci haftada elde edilen elektrofizyolojik ve histopatolojik veriler gergi dikişli grupta diğer gruplara göre anlamlı olarak daha iyiydi, bu da en iyi erken ve geç sinir iyileşmesinin bu grupta olduğunu göstermektedir.

Keywords

nörorafi, gergi dikişi, sinir iyileşmesi, uçtan uca

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