Comparison of Nerve Repair Techniques: Suture Vs. Avitene-Polyglycolic Acid Tube

ABSTRACT

A study was designed to determine whether a completely sutureless technique of nerve repair using avitene and polyglycolic acid (PGA) tube could provide a better repair than the standard suture repair technique. Randomized peroneal nerves of 18 male Sprague-Dawley rats were used. The study was divided into two parts. The first part was designed to test the adhesive and tensile strength of avitene at the second postoperative day in seven animals. The tensile strength of the suture repair at 498 mN ± 130 was found to be statistically equivalent (p = 0.77) to the repair using avitene and PGA tube at 474 mN ± 192. The second part of the study evaluated axonal regeneration in 11 animals. Evaluation by electrophysiology revealed a significant difference (p = 0.05) between the mean percentage of Integrated Mean Compound Action Potential for the suture repaired nerve (53.1 ± 17.6 percent) and that of the avitene and PGA tube repaired nerve (72.0 ± 17.9). The mean axonal count and mean fiber diameter for the suture repair technique (1,879 ± 225 and 4.3 ± 0.4 μm, respectively) were not significantly different (p = 0.61 and 0.67, respectively) from those of the avitene-PGA tube repair technique (1,938 ± 398 and 4.2 ± 0.4 fim, respectively).