Insulation of simultaneous arterial and nerve repairs in the rat: the effectiveness of the autologous vein graft

The use of a vein graft as a barrier between arterial and nerve repair sites has not been reported previously. The aim of this study is to present the possible use of the vein graft for insulating a nerve repair site from an adjacent arterial anastomosis. Bilateral longitudinal incisions were created on 5 Sprague-Dawley rats. Bilateral nerve coaptations and femoral artery repairs were performed. The left nerve repair site was wrapped with the vein graft obtained from the ipsilateral femoral vein. At the postoperative second month, the repair sites were visually evaluated. Blunt dissection between the nerve and the artery was performed and specimens were obtained for histopathological evaluation. There were no signs of absorption or degradation of the graft under the operating microscope. Minimal adhesions were noticed between the vein-wrapped nerve and the artery. In the vein-wrapped side, mechanical dissection was significantly easier. Histopathological evaluation revealed sufficient insulation of the nerve from the artery repair site. Vein grafts can be used in order to prevent adhesions between repair sites of adjacent injured structures. Despite the favorable results achieved in this model, we do not urge the routine use of this method in every clinical situation. However in a clinical setting that an extensive fibrosis is expected, such as combined and multiple injuries affecting tendons, nerves and arteries, we believe the technique has a place as a favorable adjuvant procedure.