Study of nerve regeneration in centrocentral anastomosis

Abstract

Nerve regeneration was studied in a model of centrocentral anastomosis (CCA) performed on the sciatic nerve of the rat. Experimental CCA was made by suturing the proximal end of the peroneal branch on the proximal end of the sural branch, placing between them a peroneal nerve graft (Group I, 20 rats) or a silicone chamber (Group II, 12 rats). Nerve grafts had a length of 5 mm and silicone chambers 7 mm. In six silicone chambers an 1 mm nerve graft was placed in the centre of the tube. In group I animals anterograde degeneration was studied by cutting the graft 60 days after surgery. In group II, nerve regeneration was studied 2, 4 and 8 weeks after surgery. Results indicate that in CCA: 1) regenerated axons coming from one nerve end grow into the graft but do not cross the contralateral suture line; 2) regeneration is poorer in silicone chambers than in nerve grafts; and 3) in silicone chambers regeneration is related to time. The reduction in the regenerative capability in CCA seems to be related to the alteration of nerve sprouts aiming for the peripheral targets.

Centro-Central Union for the Prevention of Neuroma Formation after Finger Amputation

“…There is further evidence from animal studies that suturing nerve ends of comparable diameter with a section of autograft helps minimize the incidence of neuroma formation (Gonza lez-Darder et al, 1985). Nerve ®bres are observed to grow into the autograft, mingle and cross but they do not grow beyond the distal suture line into the opposing nerve stump (Gil-Salu and Gonza lez-Darder, 1990). In the treatment of existing neuroma, histological studies following CCU have demonstrated cessation of axonal proliferation, (Gorkisch et al, 1984), with a reduction in the size of the neuroma (Gonza lez-Darder et al, 1985).…”

Abdominoinguinal Pain Syndrome Treated by Centrocentral Anastomosis

“…Because reconstruction was not possible, he connected their central stumps with interposed segment. Almost all followers performed suturing with an interposed segment and they explained the success of centrocentral anastomosis by the fact that the growing of axons is supressed and a neuroma is not formed [1,5,6,12,17]. Therefore the interposed segment of nerve was recommended as a graft.…”