The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments
BACKGROUND: Preparation of nerve ends is an essential part of nerve repair surgery. Multiple instruments have been described for this purpose; however, no consensus exists regarding which is the least traumatic for tissue handling. We believe that various instruments used for nerve-end excision will...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116000/ https://www.ncbi.nlm.nih.gov/pubmed/33996348 http://dx.doi.org/10.1097/GOX.0000000000003566 |
_version_ | 1783691297715912704 |
---|---|
author | Rose, Ryan Adam Bliss, Ryan Bromage, Timothy Hu, Bin Gopman, Jared M. Melamed, Eitan |
author_facet | Rose, Ryan Adam Bliss, Ryan Bromage, Timothy Hu, Bin Gopman, Jared M. Melamed, Eitan |
author_sort | Rose, Ryan Adam |
collection | PubMed |
description | BACKGROUND: Preparation of nerve ends is an essential part of nerve repair surgery. Multiple instruments have been described for this purpose; however, no consensus exists regarding which is the least traumatic for tissue handling. We believe that various instruments used for nerve-end excision will lead to different surface roughness. METHODS: Median and ulnar nerves from fresh frozen cadavers were dissected, and 1–2 cm lengths were excised using a No. 11 blade, a razor blade, or a pair of scissors. Using electron microscopy, 3-dimensional surface analysis of roughness (Sa) for each specimen was performed using ZeeScan optical hardware and GetPhase software (PhaseView, Buisson, France). An ANOVA or Kruskal-Wallis test compared roughness measures among cutting techniques. RESULTS: Forty nerves were included. Of these, 13 (32.5%) were cut using scissors, 15 (37.5%) using a razor blade, and 12 (30%) using a No. 11 blade. An ANOVA test showed statistical differences in Sa among the cutting techniques (P = 0.002), with the lowest mean Sa noted in the scissors group (7.2 µM, 95% CI: 5.34–9.06), followed by No. 11 blade (7.29 µM, 95% CI: 5.22–9.35), and razor blade (11.03 µM, 95% CI: 9.43–12.62). Median Ra (surface profile roughness) was 4.58 (IQR: 2.62–5.46). A Kruskal-Wallis test demonstrated statistical difference in Ra among techniques (P = 0.003), with the lowest by No. 11 blade (3 µM, IQR: 1.87–4.38), followed by scissors (3.29 µM, IQR: 1.56–4.96), and razor (5.41 µM, IQR: 4.95–6.21). CONCLUSION: This novel technique of 3-dimensional surface analysis found razor blade use demonstrated poor roughness, whereas a No. 11 blade or nerve-specific scissors led to equivocally smooth nerve ends. |
format | Online Article Text |
id | pubmed-8116000 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-81160002021-05-14 The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments Rose, Ryan Adam Bliss, Ryan Bromage, Timothy Hu, Bin Gopman, Jared M. Melamed, Eitan Plast Reconstr Surg Glob Open Hand/Peripheral Nerve BACKGROUND: Preparation of nerve ends is an essential part of nerve repair surgery. Multiple instruments have been described for this purpose; however, no consensus exists regarding which is the least traumatic for tissue handling. We believe that various instruments used for nerve-end excision will lead to different surface roughness. METHODS: Median and ulnar nerves from fresh frozen cadavers were dissected, and 1–2 cm lengths were excised using a No. 11 blade, a razor blade, or a pair of scissors. Using electron microscopy, 3-dimensional surface analysis of roughness (Sa) for each specimen was performed using ZeeScan optical hardware and GetPhase software (PhaseView, Buisson, France). An ANOVA or Kruskal-Wallis test compared roughness measures among cutting techniques. RESULTS: Forty nerves were included. Of these, 13 (32.5%) were cut using scissors, 15 (37.5%) using a razor blade, and 12 (30%) using a No. 11 blade. An ANOVA test showed statistical differences in Sa among the cutting techniques (P = 0.002), with the lowest mean Sa noted in the scissors group (7.2 µM, 95% CI: 5.34–9.06), followed by No. 11 blade (7.29 µM, 95% CI: 5.22–9.35), and razor blade (11.03 µM, 95% CI: 9.43–12.62). Median Ra (surface profile roughness) was 4.58 (IQR: 2.62–5.46). A Kruskal-Wallis test demonstrated statistical difference in Ra among techniques (P = 0.003), with the lowest by No. 11 blade (3 µM, IQR: 1.87–4.38), followed by scissors (3.29 µM, IQR: 1.56–4.96), and razor (5.41 µM, IQR: 4.95–6.21). CONCLUSION: This novel technique of 3-dimensional surface analysis found razor blade use demonstrated poor roughness, whereas a No. 11 blade or nerve-specific scissors led to equivocally smooth nerve ends. Lippincott Williams & Wilkins 2021-05-10 /pmc/articles/PMC8116000/ /pubmed/33996348 http://dx.doi.org/10.1097/GOX.0000000000003566 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Hand/Peripheral Nerve Rose, Ryan Adam Bliss, Ryan Bromage, Timothy Hu, Bin Gopman, Jared M. Melamed, Eitan The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments |
title | The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments |
title_full | The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments |
title_fullStr | The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments |
title_full_unstemmed | The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments |
title_short | The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments |
title_sort | cutting edge: surface texture analysis following resection of nerve stumps using various instruments |
topic | Hand/Peripheral Nerve |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116000/ https://www.ncbi.nlm.nih.gov/pubmed/33996348 http://dx.doi.org/10.1097/GOX.0000000000003566 |
work_keys_str_mv | AT roseryanadam thecuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT blissryan thecuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT bromagetimothy thecuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT hubin thecuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT gopmanjaredm thecuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT melamedeitan thecuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT roseryanadam cuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT blissryan cuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT bromagetimothy cuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT hubin cuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT gopmanjaredm cuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments AT melamedeitan cuttingedgesurfacetextureanalysisfollowingresectionofnervestumpsusingvariousinstruments |