Small Gap Suture Combined With Nerve Fragments In The Experimental Study Of The Rat Nerve Defects

Objective:To study the effect of nerve fragments and small gap suture of epineurium in peripheral nerve repair, as clinical peripheral nerve injury repair theoretical basis.Methods:1,Establishing animal model:The experimental animals were randomly divided into control group, simple small gap suture group, small gap suture combined neural debris group, the control group was taken with traditional epineurium suture; small clearance suture combined nerve fragmented group, with a small gap suture, filled with nerve debris.2, General observation:after8weeks of surgical operation under sterile conditions, observing regenerated nerve in nerve ends.3, Histological observation:4and8weeks after surgery, taking the middle of the sutured regenerated nerve about3mm, according to HE staining, observing axons and myelin formation of the regenerated nerve fiber with light microscopy.4、 Gastrocnemius wet weight ratio:stripping bilateral sciatic nerves and appearing hind limb full-length gastrocnemius, which was completly removed at the the tendon ending point, measured with electronic balance and calculated the ratio of wet weight.5、Pathological image analysis:Calculating he number of regenerated nerve fiber,and observing the ultrastructure of regenerated nerve,to obtain the diameter and myelin thickness of regenerated nerve fiber.Results:1, The general morphology of anastomotic:Scar tissue was formed in traditional suture anastomosis adhesions; In simple small gap suture group, no obvious adhesions with the surrounding tissue, no significant scar tissue, no neuroma formation, no obvious change in the outer membrane of the small gap; small gap suture combined nerve debris group, no obvious adhesions,scar tissue and neuroma formation at anastomotic,the outer membrane of small gap turned thinner than before;2,Compared to the normal control group, the wet weight ratio was increased significantly in the small-gap suture group, compared with the small gap group, tbe wet weight increased significantly in the small gap plus nerve fragments group;3,Compared with the control group, the total number of myelinated nerve fibers was increased significantly in the small-gap suture group and small gap plus nerve fragments group, compared to the simple small-gap suture group, the number of nerve fibers was increased in small gap plus nerve debris group.4, after8weeks, compared with the control group, the diameter of the nerve fibers and myelin thickness were increased significantly in simple small gap group and the small gap plus nerve debris group.5, Histological observation:in small gap group and nerve fragments plus small gap group,we can see that the regenerated nerve fibers were evenly distributed, in small gap plus nerve fragments group, the intensity of the nerve fibers was increased than the small gap group. The nerve fibers of the control group appear irregular arrangement,myelinated nerve fiber deformation, disintegration, no continuous myelinated nerve fibers.Conclusion:The nerve fragments plus epineurium small gap suture has a significant role in the repair of peripheral nerve injury, providing the foundation for clinical peripheral nerve injury repair.