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

Abstract

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.