1. SCARLESS: A REVIEW OF SCAR
REDUCTION AT SITES OF
PERIPHERAL NERVE REPAIR
(WEI CHEONG NGEOW , BDS (MAL), FFDRCS (IRELAND), FDSRCS
(ENG), MDSC (MAL), KUALA LUMPUR, MALAYSIA – UNIVERSITY OF
MALAYA
Dr. Nikitha Sree. K
Lecturer
Malabar Dental College and Research Centre
2. Scar formation is important for normal wound
healing but proliferation of scar tissue from the
epineurium in response to a nerve injury will result
in impediment to the regenerating axons that need
to traverse the repaired site.
Scarring interferes with growth, causes deformities,
and impairs normal function.
This article reviews the challenges that need to be
addressed to reduce scarring in order to improve
nerve regeneration.
3. SURGICAL APPROACHES TO REDUCE
INTRANEURAL SCARRING
Epineural, perineural, and interfascicular suture
techniques have been advocated for this purpose,
with the later two being more precise alignment of
fascicles and approximation of reconnection is
higher in perineural repair.
Intraneural scarring may develop if the severed
nerve ends are not well coapted during repair.
Another cause is a suture provoked foreign body
reaction
Suture placement has also been suggested to
hinder sprouting axons and compress the blood
supply to the fascicles.
4. Other approaches include nerve adhesion with
fibrin glue and the use of CO2 laser welding.
One study showed the application of fibrin glue as a
cuff reduced inflammation and avoided the
production of suture granulomas.It also enhanced
nerve regeneration.
Fibrin glue act as a sealant , allows axonal
regeneration even if it is placed interposition
between two nerve stumps.
It is a simple technique and less time consuming
than suturing.
