In order to further improve and explore the role of
lasers for nerve reconstruction, this study was designed to investigate regeneration of sharply transected peripheral nerves repaired with a CO(2) milliwatt
laser in combination with three different
suture materials and a
bovine albumin protein solder as an adjunct to the welding process. Unilateral sciatic nerve repair was performed in 44 rats. In the
laser group, nerves were gently apposed, and two stay
sutures (10-0
nylon, 10-0
polyglycolic acid, or 25 microm
stainless steel) were placed epi/perineurially. Thereafter, the repair site was fused at 100 mW with pulses of 1.0 s. In the subgroup of
laser-assisted nerve repair (LANR), albumen was used as a soldering agent to further reinforce the repair site. The control group consisted of nerves repaired by conventional microsurgical
suture repair (CMSR), using 4-6 10-0
nylon sutures. Evaluation was performed at 1 and 6 weeks after surgery, and included qualitative and semiquantitative light microscopy. LANR performed with a
protein solder results in a good early peripheral nerve regeneration, with an optimal alignment of nerve fibers and minimal connective tissue proliferation at the repair site. All three
suture materials produced a
foreign body reaction; the least severe was with
polyglycolic acid sutures. CMSR resulted in more pronounced
foreign-body granulomas at the repair site, with more connective-tissue proliferation and axonal misalignment. Furthermore, axonal regeneration in the distal nerve segment was better in the
laser groups. Based on these results, CO(2)
laser-assisted nerve repair with soldering in combination with absorbable
sutures has the potential of allowing healing to occur with the least
foreign-body reaction at the repair site. Further experiments using this combination are in progress.