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手术刀边缘粗糙度影响横断后周围神经再生。

Scalpel edge roughness affects post-transection peripheral nerve regeneration.

作者信息

Prescher Hannes, Ling Michelle X, Bigdelle Victoria, Spiro Clifford L, Lee Raphael C

机构信息

Laboratory for Molecular Regeneration, Section of Plastic and Reconstructive Surgery, The University of Chicago, Chicago, IL 60637.

出版信息

Surg Open Sci. 2020 Nov 18;4:1-6. doi: 10.1016/j.sopen.2020.11.002. eCollection 2021 Apr.

DOI:10.1016/j.sopen.2020.11.002
PMID:33537665
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7838729/
Abstract

BACKGROUND

Gentle and precise tissue dissection reduces collateral tissue damage and preserves its structural quality for optimizing healing. This is particularly true for peripheral nerve neurorrhaphy. Axon regeneration kinetics across the repair is dependent on the amount of intraneural fibrosis. The purpose of this study was to determine whether scalpel blade smoothness was a deterministic factor in the kinetics of postneurorrhaphy peripheral axon regeneration.

METHODS

Scalpel transection of the saphenous nerve was performed in 18 female Hartley guinea pigs either by a standard #15 stainless steel scalpel blade or a highly polished version of the same blade. Compound nerve action potential recordings and histochemical assay of neurofilament density proximal and 1 cm distal to the site of nerve transection were quantified postneurorrhaphy at postoperative weeks 5, 9, and 12.

RESULTS

There was no action potential transmission observed in the distal axons immediately after neurorrhaphy. A substantial acceleration of axonal conduction recovery was observed in nerves transected with polished scalpel blades observed by high compound nerve action potential amplitudes at postneurorrhaphy weeks 5 and 9 (P < .05). In addition, an increased recovery of intra-axonal neurofilament density in nerves transected with polished scalpel blades was observed by postoperative week 5 (P < .05).

CONCLUSION

The quality of the scalpel blade is an important determinate of postsurgical healing. Gentle handling of tissue matters.

摘要

背景

轻柔且精确的组织解剖可减少附带组织损伤，并保留其结构质量以优化愈合。这在周围神经神经缝合术中尤为如此。修复部位的轴突再生动力学取决于神经内纤维化的程度。本研究的目的是确定手术刀刀片的光滑度是否是神经缝合术后周围轴突再生动力学的决定性因素。

方法

对18只雌性哈特利豚鼠的隐神经进行手术刀横断，分别使用标准的#15不锈钢手术刀刀片或同一刀片的高度抛光版本。在术后第5、9和12周进行神经缝合术后，对神经横断部位近端和远端1 cm处的复合神经动作电位记录以及神经丝密度的组织化学分析进行量化。

结果

神经缝合术后立即在远端轴突中未观察到动作电位传导。在术后第5周和第9周，用抛光手术刀刀片横断的神经中观察到轴突传导恢复显著加速，复合神经动作电位幅度较高（P <.05）。此外，到术后第5周时，用抛光手术刀刀片横断的神经中轴突内神经丝密度的恢复增加（P <.05）。

结论

手术刀刀片的质量是术后愈合的重要决定因素。轻柔处理组织很重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/ddf7297f4d92/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/707a96de3744/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/75a480f969a1/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/1dfb795f52de/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/28c0e219a16a/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/ddf7297f4d92/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/707a96de3744/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/75a480f969a1/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/1dfb795f52de/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/28c0e219a16a/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e917/7838729/ddf7297f4d92/gr5.jpg

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