Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Microsurgery. 2010;30(3):218-22. doi: 10.1002/micr.20754.
Microneurosurgical technique has a steep learning curve. An alternative to microepineurial suture repair of peripheral nerves that circumvents this learning curve would be ideal. We investigated the effect of surgeon experience on suture versus fibrin glue coaptations in a mouse sciatic nerve graft model. Sixty-four mice received sciatic nerve grafts with either suture or fibrin glue repair by either a naïve surgeon (medical student) or a surgeon with extensive microsurgical experience. Grafts underwent quantitative histomorphometry at 3 weeks postoperatively. Suture repairs performed by the naïve surgeon demonstrated significantly poorer distal regeneration than all other repairs. Histomorphometric parameters of suture and glue repairs performed by the experienced surgeon were not significantly different from the glue coaptation by the naïve surgeon. Fibrin glue may be considered as an alternative to microepineurial suture repair, particularly in the setting of relative surgeon inexperience with microsurgical technique.
显微神经外科技术的学习曲线陡峭。如果有一种替代方法可以绕过这个学习曲线，对周围神经进行微创外膜缝合修复，那将是非常理想的。我们研究了外科医生经验对小鼠坐骨神经移植模型中外膜缝合与纤维蛋白胶吻合的影响。64 只小鼠接受了坐骨神经移植，由一名新手外科医生（医学生）或一位具有丰富显微外科经验的外科医生进行外膜缝合或纤维蛋白胶修复。术后 3 周进行定量组织形态计量学检查。新手外科医生进行的外膜缝合修复显示出明显较差的远端再生，明显差于所有其他修复。经验丰富的外科医生进行的外膜缝合和纤维蛋白胶修复的组织形态计量学参数与新手外科医生进行的纤维蛋白胶吻合没有显著差异。纤维蛋白胶可以被认为是微创外膜缝合修复的替代方法，特别是在外科医生相对缺乏显微外科技术经验的情况下。
