Mitz V, Leviet D, Vilain R
Nouv Presse Med. 1979 Sep 17;8(35):2815-8.
In the presence of peripheral nerve damage, the only acceptable procedure is suture without tension, carried out under excellent conditions of fascicular approximation. In the case of loss of substance, immediate or secondary suture should never be performed. In the experience of "S.O.S. Main" secondary suture has led to the most disastrous results. Nerve graft, as an emergency, is legitimate in the case or reimplantations, in view of the high degree of technical competence of the teams, and the experience acquired. Deffered nerve graft is envisaged at about the end of the second month:--either in the absence of suture,--or in the absence of recovery. When there is any doubt, further examination at the 4 th or 5 th month ensures that treatment is not delayed too long. At all events, examinations must be repeated every two months in order to study nerve regrowth and to determine the need for possible though difficult reoperation if it stops.
在周围神经损伤的情况下,唯一可接受的手术是在束膜精确对合的良好条件下进行无张力缝合。在神经实质缺失的情况下,绝不应进行一期或二期缝合。根据“S.O.S. Main”的经验,二期缝合导致了最灾难性的后果。鉴于团队的高技术水平和已积累的经验,在再植手术中,作为紧急措施,神经移植是合理的。预计在第二个月末进行延期神经移植:——要么是在无法进行缝合时,——要么是在没有恢复迹象时。当存在任何疑问时,在第四或第五个月进行进一步检查可确保治疗不会延迟太久。无论如何,必须每两个月重复进行检查,以便研究神经再生情况,并确定如果神经再生停止是否需要进行可能难度较大的再次手术。