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Primary Nerve Repair



- 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.