Primary versus secondary nerve repair: a review of the literature.

The pros and cons of primary and secondary neurorrhaphy are discussed on the basis of a study of the literature. The impression is gained that recently, many surgeons have come to prefer secondary restoration of the continuity of a severed peripheral nerve. However, the longer the delay, the more serious the problems and the worse the prognosis. The authors conclude therefore that repair of the nerve in the earliest possible stage should always be attempted. Provided the relevant conditions are fulfilled, primary neurorrhaphy should be seriously considered; the prognosis of primary repair is good, especially in children. If primary neurorrhaphy is contra-indicated, early secondary repair is to be preferred to further delay.