An evaluation using techniques to assess muscle and nerve regeneration of a flexible glass wrap in the repair of peripheral nerves.

In this study a flexible biodegradable wrap is compared with microsurgical epineurial suturing in the repair of cleanly divided peripheral nerves. Five groups of twelve sheep were used; one control group and four neurotmesis and repair groups. The four repair groups were; (1) Epineurial suture repair using a microscope and 9/0 polyamide; (2) Wrap secured by Tisseel glue; (3) Wrap secured by polycaprolactone glue; (4) Wrap secured by suturing. Regeneration of the median nerve was assessed by electromyography, nerve conduction studies, wet muscle mass measurements, and morphometry. The results suggested that nerve regeneration in the wrap+Tisseel glue group was as good as that in the epineurial repair group. The use of polycaprolactone glue is not recommended in nerve repair. Placement of the wrap was easy to learn and quick to carry out under direct vision. The wrap used in this study could prove to be a useful alternative to epineurial suturing to repair peripheral nerves and may have a particularly unique role in the developing world and battlefield.