- Discussion:
- in sharp clean wounds primary repair is indicated;
- by definition primary repair is performed within 7 days of injury;
- age of the patient is single most critical factor in sensory recovery after nerve repair, & results are adversely affected by associated
injuries to muscle, tendon, and bone;
- advantages:
- include lack of scarring;
- minimal dissection because the nerve ends have not retracted and become inbedded in scar;
- one less operative procedure being required;
- facilitation of recovery of motor functionn by early repair;
- w/ long delays, there is more shrinkage of the distal nerve segment, and there is more atrophy of end organs;
- indications for delayed repair:
- nerve division by a blunt instrument that inflicts more tissue damage than is readily apparent, such as the case with GSW;
- avulsion injuries;
- grossly contaminated injuries
The time factor in surgery of upper extremity peripheral nerve injury.