Thomas B. Ducker

Experimental Improvements in the Use of Silastic Cuff for Peripheral Nerve Repair

F OR nearly 90 years experimental and clinical evidence has favored structural support about a nerve repair 7,~7 with a material that permitted direct and reproducible maximal axonal spanning without axonal disorganization or connective tissue build-up. Only during the past year has such a material become available. 4 This material, Silastic, formed into thin, elastic tubes was tested in chimpanzees against thicker tubes of the same material, wraps of millipore, collagen, or silicone, and against standard epineural suturing without wrapping. The results have been promising? However, ill-fitting tubes, regardless of the material, can strangulate a nerve anastomosis if too tight or fail to support it if too loose. 13 Therefore, establishing the best cuff dimensions, including such specifications as the proper ratio between the cross-section area of the nerve and the tube, became an important prerequisite to clinical trials. This report describes refinements in the technical details of nerve repair utilizing a Silastic cuff.

Comparative pathology after intrathecal endotoxin in the rabbit, dog and monkey

Pathologische Veränderungen bei Kaninchen, Hunden und Affen nach intrazysternaler Verabreichung von Bakterienendotoxinen sind einander sehr ähnlich, während sie nach i.v. Injektion bei allen 3 Tiergruppen auffallend verschieden sind. Dies führt zur Annahme, dass die Wirkung des Endotoxins zur Hauptsache offenbar nicht über das Zentralnervensystem geht.

Surgery for Spinal Cord Injuries

Nearly 50 000 persons sustain serious spinal column trauma annually. Approximately 10% to 20% of them suffer injury to the nervous system. When there is a complete deficit, the consequences are disastrous. With serious trauma, our standard guidelines of care must apply. Treating the bony spinal column, which surrounds the nervous system, requires special expertise. More and more of these patients are being treated surgically, because surgery achieves immediate stabilization and a more rapid entry into a rehabilitation program. In this textbook, the initial chapters are devoted to timing and selection of the operative procedure. Choices are influenced by the exact neurologic deficit, and here the various syndromes are well described. Nuances of surgical care that include minimizing blood loss and proper intraoperative monitoring are well covered in their separate chapters. Thereafter, the book embarks on a consideration of specific areas of the spine and the treatment they require. The