Vein graft conduits versus conventional suturing in peripheral nerve reconstructions

Positive results of tubulization in peripheral nerve reconstruction have been established in animals by many investigators. Clinically, tubulization by means of a venous tubulus is accepted as a reliable technique, but histological results are not known and functional analysis is limited. The aim of this investigation was to study the histological effect of venous tubuli in peripheral nerve reconstruction. In 20 rabbits the saphenous nerves were transected and anastomosed. In ten rabbits (series 1) a venous tubulus was placed around the nerve suture. In another ten rabbits (series 2) a venous tubulus was sutured over a 3 mm nerve gap. Conventional suturing was done in ten contralateral saphenous nerves (series 3, controls). Epineurial stitching was performed. The healing was studied after 3 months and after that histological analysis was performed by means of monoclonal antibody staining. The results of our experiments show that covering a nerve anastomosis with a venous tubulus did not enhance healing in comparison to the conventional end-to-end anastomosis, but in contrast evoked extensive fibrous tissue, thereby hampering regeneration of axons.