Morphological changes of the nerve after restorative treatment using electric welding technology (experimental study)

Keywords: peripheral nerve; epineural welding; partial hindlimb immobilization; regenerative neuroma.


Objective – to study morphological features regenerative nerve neuroma after a complete intersection and restorative surgery with the use of electric welding technology.
Materials and methods. The experimental model of operative intervention on injured peripheral nerve by immediate nerve stump’s epineurium welding and partial hindlimb immobilization was developed. The study was performed on 66 white, non-breeding male rats aged 5–7 months with a body weight of 350–450 g of vivarium breeding in Institute of Neurosurgery named after acad. A.P. Romodanov NAMS of Ukraine. Animals were divided into four experimental groups: 1 – surgical animals that included access to the sciatic nerve and its full intersection (n = 21), 2 – animals that were surgically intervened, which included access to the sciatic nerve, its intersection and the restoration of anatomical integrity by the application of an epineural suture (n = 18), 3 – animals that were operated surgically, which included access to the sciatic nerve, its intersection and the restoration of anatomical integrity by electric welding of the epineurium of the ends (n = 21), 4 – sham group, who were given access to the transverse nerve without its intersection (n = 6). In the experimental group of electric welding, the operation was performed using the apparatus EKWZ-300, «Patonmed» in the automatic mode dA2, with variable high-frequency (440 kHz) modulated current up to 0,3 A, the voltage at the 34 V pincer shield, the duration of the rectangular exposure pulse 0.8 s.
Formated 5–6 electric weld point connections along the perimeter of the intersection with a complete alignment of the ends. The neurohistological method of study was used to study the morphological picture of the peripheral nerve in the region of the regenerative neurology and the distal segment in 1 and 3 months after surgical intervention.
Results. It was established that simultaneous use of the technique of welded epineural joint of parts and partial immobilization of the limb in the postoperative period leads to uniform maturation of the neuro-connective tissue and its more complete neuroticisation.
Conclusions. Recovery processes in the injured peripheral nerve occur better with the simultaneous formation of an immediate welded epineural joint of the ends and partial immobilization of the limb.


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Grinsell D, Keating CP. Peripheral nerve reconstruction after injury: a review of clinical and experimental therapies. Biomed Res Int. 2014;2014:698256. doi: 10.1155/2014/698256. Epub 2014 Sep 3. Review. PubMed PMID: 25276813; PubMed Central PMCID: PMC4167952.

Barton MJ, Morley JW, Stoodley MA, Lauto A, Mahns DA. Nerve repair: toward a sutureless approach. Neurosurg Rev. 2014 Oct;37(4):585-95. doi: 10.1007/s10143-014-0559-1. Epub 2014 Jul 13. Review. PubMed PMID: 25015388.

Félix SP, Pereira Lopes FR, Marques SA, Martinez AM. Comparison between suture and fibrin glue on repair by direct coaptation or tubulization of injured mouse sciatic nerve. Microsurgery. 2013 Sep;33(6):468-77. doi: 10.1002/micr.22109. Epub 2013 Jul 9. PubMed PMID: 23836677.

Mokarram N, Dymanus K, Srinivasan A, et al. Immunoengineering nerve repair. Proc Natl Acad Sci U S A. 2017 Jun 27;114(26):E5077-E5084. doi: 10.1073/pnas.1705757114. Epub 2017 Jun 13. PubMed PMID: 28611218; PubMed Central PMCID: PMC5495274.

Patent Ukrainy na korysnu model № 101487, MPK (2015.01) A61D 1/00 G09B 23/28 (2006.01). Sposib vidnovlennia prostorovoi tsilisnosti travmovanoho peryferychnoho nerva statevozrilykh shchuriv-samtsiv / Tsymbaliuk V.I, Molotkovets V.Iu, Kvasha M.S, Medvediev V.V, Molotkovets K.M; Zaiavnyk ta patentovlasnyk DU “Instytut neirokhirurhii im. akad. A.P. Romodanova NAMN Ukrainy”. N u2015 04142; zaiavl. 28.04.2015; opubl. 10.09.2015, Biul. No.17. (in Russian)

Landman J, Kerbl K, Rehman J, et al. Evaluation of a vessel sealing system, bipolar electrosurgery, harmonic scalpel, titanium clips, endoscopic gastrointestinal anastomosis vascular staples and sutures for arterial and venous ligation in a porcine model. J Urol. 2003 Feb;169(2):697-700. PubMed PMID: 12544345.

Lachanas VA, Hajiioannou JK, Karatzias GT, et al. Comparison of LigaSure vessel sealing system, harmonic scalpel, and cold knife tonsillectomy. Otolaryngol Head Neck Surg. 2007 Sep;137(3):385-9. PubMed PMID: 17765762.

Tirelli G, Camilot D, Bonini P, et al. Harmonic scalpel and electrothermal bipolar vessel sealing system in head and neck surgery: a prospective study on tissue heating and histological damage on nerves. Ann Otol Rhinol Laryngol. 2015 Nov;124(11):852-8. doi: 10.1177/0003489415588556. Epub 2015 Jun 15. PubMed PMID: 26077393.

Privalova I.L, Lipatov V.A, Zatolokina M.A, Gamazinov I.N, Proskurina I.V. Morfologicheskie kriterii travmaticheskogo povrezhdenija sedalishhnogo nerva i okruzhajushhih ego tkanej v jeksperimentalnyh issledovanijah na laboratornyh krysah (obzor literatury) (in Russian). Nauchnyj jelektronnyj zhurnal INNOVA (in Russian). 2016:4(5).

How to Cite
Molotkovets, V. Y. (2019). Morphological changes of the nerve after restorative treatment using electric welding technology (experimental study). Ukrainian Interventional Neuroradiology and Surgery, 27(1), 91-98.