Operations on the peripheral nerves
Neurology / / April 29, 2016
operations on the nervous system
most often produce the operation of primary and delayed nerve suture.The primary seal is applied in the debridement of primary, secondary - may be formed after a few weeks or months after injury.Isolation of scarring and adhesions intact (or partially damaged) nerve called neurolysis.
primary nerve suture. surgery Tasks - allocation of nerve, its inspection and electrodiagnosis, mobilization of all to eliminate the tension, resection of the damaged areas (refreshment of all the nerve), suturing, wound closure, immobilization of a limb.
In preparation for nerve suture surgery is necessary to know the following.
1. When nerve injury his outer sheath (epineurium) may not be damaged, and the nerve bundles which lie inside the epineurium may be broken.Determine the location of the nerve damage and resection borders by external examination is sometimes difficult, so the use of electro on the operating table.Apply a special apparatus that supplies pulsed current.T
2. Resection of the damaged portion of the nerve should be done within a viable nerve bundles.For greater certainty that the nerve resected within healthy tissue, cross-sections inspected during surgery through a magnifier or surgical microscope (if available in the hospital).So sister prepares for sterile operation in conjunction with a magnifying glass or a surgeon - surgical microscope.
3. When the primary surgical treatment of wounds, when there is nerve damage, tendons, blood vessels, first produced ligation or suture of the vessel, tendon, and only then on the nerve.Therefore, prepare everything you need for debridement, taking into account the damage of the vessel or tendons, as well as tools and material for nerve suture.
4. After suturing to nerve epineurium decided to impose on the central and peripheral ends (near the seam) in a single metal clip.This allows you to make the postoperative x-ray of the limbs and on the Status of clips, to judge the state of the seam.In this regard, a sister operation to prepare and store clips klipsoderzhatel.
5. After suturing the nerve to give the position of the limbs, which provides the least tension-linked nerve ends.This requires a cast.