Surgical Results of the Use of Expanded Polytetrafluor Ethylene as an Adhesion Inhibitory Membrane in Anastomosis Surgery for Total Peripheral Nerve Cut

Abstract

The fibrotic tissue that appears following nerve damage can prevent axonal regeneration. Expanded polytetrafluor ethylene (ePTFE) is a synthetic polymer with antiadhesive properties and a safe history of use in neurosurgery. The aim of this study was to use ePTFE to prevent postsurgical adhesions in patients undergoing anastomosis surgery and report the results. Between January 2014 and May 2018, six patients with primary and secondary peripheral nerve cuts underwent anastomosis (one with allograft and five with autografts). The anastomotic region was wrapped with ePTFE to form a barrier. The mean follow-up period was 28 months (minimum 3 months, maximum 4 years). In three of six patients whose nerve integrity was lost due to various reasons, there was an improvement in electrophysiological recordings. The allograft was used in a patient with peroneal nerve injury; the sural nerve was used as a graft in other patients. In three patients, the defect was more than 4 cm. Early surgery and defect size are important factors to consider when treating peripheral nerve anastomosis. Development of intraneural and perineural adhesions postsurgery can be problematic. ePTFE is an inert polymer that prevents adhesions from forming after anastomosis surgery.