Immediate versus delayed primary repair of the sciatic nerve in a nerve transaction model in rats

BACKGROUND: The debate continues concerning surgical timing in a peripheral nerve injury. This study aims to evaluate the result of immediate versus delayed primary (after seven days) repair of peripheral nerve injury.
METHODS: In this study, Wistar rats were divided into four groups as follows: The nerve was sharply transected in Group 1, 2 and 4. It was immediately sutured in Group 1 and sutured seven days later in Group 2, and it was not sutured in Group 4. In Group 3, the left sciatic nerve was only explored. Eight weeks later, tissue samples were extracted from the injured nerve area. Both gastrocnemius muscles were weighed. The nerve samples were examined for axon degeneration. Myelin vacuolization, axon irregularity, and edema/inflammation parameters were evaluated.
RESULTS: There were not any significant differences in the score of axon degeneration and the weight of the gastrocnemius muscle between the immediate and delayed primary repair groups. However, these parameters were significantly better in both repair groups than to be in the control group and significantly worse than to be in the sham-operated group.
CONCLUSION: To delay the repair about one week did not affect the histological results and weight of the muscle that was innervated by the sectioned nerve comparing to be in the immediate repair in a sciatic nerve transaction model in rats.

Sýçanlarda sinir transeksiyon modelinde siyatik sinirin acil ve gecikmeli primer onarýmý

AMAÇ: Periferik sinir yaralanmasýnda cerrahinin zamanlamasý hala tartýþmalýdýr. Periferik sinir hasarýnýn derhal ve gecikmiþ primer (yedi gün sonra) onarýmýnýn sonuçlarý deðerlendirildi.
GEREÇ VE YÖNTEM: Wistar cinsi sýçanlar 4 gruba ayrýldý: Sinir keskin þekilde Grup 1, 2 ve 4’te kesildi. Grup 1’de hemen dikildi ve Grup 2’de yedi gün sonra dikildi ve Grup 4’te dikilmedi. Grup 3’te sol siyatik sinir sadece eksplore edildi. Sekiz hafta sonra, yaralanan sinir bölgesinden doku örnekleri alýndý. Her iki gastrocnemius kaslarý tartýldý. Sinir örnekleri akson dejenerasyonu açýsýndan incelendi. Miyelin vakuolizasyonu, akson düzensizliði ve ödem/enflamasyon parametreleri deðerlendirildi.
BULGULAR: Acil ve gecikmiþ primer onarým gruplarý arasýnda akson dejenerasyonu skoru ve gastrocnemius kasýnýn aðýrlýðý açýsýndan anlamlý fark yoktu. Bununla birlikte, bu parametreler her iki tamir grubunda da kontrol grubundan anlamlý derecede daha iyiydi ve sinir kesisi yapýlmayan gruptan anlamlý derecede daha kötüydü.
TARTIÞMA: Sýçanlarda siyatik sinir transeksiyon modelinde onarýmýn yaklaþýk bir hafta geç yapýlmasý acil onarým ile karþýlaþtýrýldýðýnda, kesilmiþ sinirin uyardýðý kasýn histolojik sonuçlarýný ve aðýrlýðýný etkilememiþtir.