Carbon dioxide laser-assisted nerve repair: effect of solder and suture material on nerve regeneration in XXXX sciatic nerve.

@entity515 @entity6886 @entity6401 @entity35 @entity291
In order to further improve and explore the role of lasers for nerve reconstruction, this study was designed to investigate regeneration of sharply transected peripheral nerves repaired with a @entity515 milliwatt laser in combination with three different suture materials and a @entity291 albumin protein solder as an adjunct to the welding process. Unilateral sciatic nerve repair was performed in 44 @entity35 . In the laser group, nerves were gently apposed, and two stay sutures (10-0 nylon, 10-0 @entity6886 , or 25 microm stainless steel) were placed epi/perineurially. Thereafter, the repair site was fused at 100 mW with pulses of 1.0 s. In the subgroup of laser-assisted nerve repair (LANR), albumen was used as a soldering agent to further reinforce the repair site. The control group consisted of nerves repaired by conventional microsurgical suture repair (CMSR), using 4-6 10-0 nylon sutures. Evaluation was performed at 1 and 6 weeks after surgery, and included qualitative and semiquantitative light microscopy. LANR performed with a protein solder results in a good early peripheral nerve regeneration, with an optimal alignment of nerve fibers and minimal connective tissue proliferation at the repair site. All three suture materials produced a foreign body reaction; the least severe was with @entity6886 sutures. CMSR resulted in more pronounced @entity6401 at the repair site, with more connective-tissue proliferation and axonal misalignment. Furthermore, axonal regeneration in the distal nerve segment was better in the laser groups. Based on these results, @entity515 laser-assisted nerve repair with soldering in combination with absorbable sutures has the potential of allowing healing to occur with the least foreign-body reaction at the repair site. Further experiments using this combination are in progress.
