Paul C. Begovac

An effective sleeving technique in nerve repair

This report describes the use of a porous polymeric sleeve (Gore-tex) to direct nerve fiber growth after axotomy. Select nerves of the triceps surae muscles in 5 adult cats were surgically isolated, sectioned, and crossed or self- reunited . A piece of Gore-tex, 15 mm in length, was compressed to 5 mm and sleeved over each distal nerve end. The appropriate proximal and distal ends were stitched together, and the Gore-tex stretched back to its original length over the suture junction. The effectiveness of the Gore-tex sleeve was assessed 4-15 months post-operatively. Electrophysiological measurements of muscle force and dorsal root volleys revealed a complete absence of unintended reinnervation and a regeneration that was more substantial for motor than sensory axons. Finally, serial histological cross-sections were prepared for each nerve above, below and at the cross union. There was no evidence of nerve tissue invading the Gore-tex wall.