Ultrastructure of Injured Peripheral Nerve Epineurium after Surgery Using High-Frequency Electric Welding Technologies at Early Regeneration Stage

Electrosurgical devices are widely used in clinical practice, but lack of information about their effects on nervous system organs restricts their usage in neurosurgery. The objective of the research was to evaluate ultrastructural changes of epineurium at early regeneration stages after surgery on peripheral nerve injury using high-frequency electrosurgical technologies. The research involved male Wistar rats. We investigated morphological features of injured peripheral nerve epineurium after nerve ends junction in different ways. Nerve stem integrity was restored using epineural sutures, electrosurgical high-frequency device at welding conditions and bipolar coagulation device. Electron microscopical study of the epineurium fragments from the injury site was conducted in 1, 3, 7, 21 days and immediately after surgery. According to obtained results, the first preliminary stage of epineurium regeneration consisting in trauma site cleaning from nonviable tissue occurs in different ways depending on epineurium coaptation method during nerve injury operative treatment in order to restore nerve stem integrity. High-frequency electrosurgical welding technology is more perspective for implementation in clinical practice due to less tissue debris formation after its application that enhances nerve regeneration. Application of high-frequency electrosurgical devices in welding mode to restore epineurium of injured nerve stem leads to protein denaturation during damaged tissue elimination. It is not accompanied by large quantity of tissue debris formation and results in soft scar tissue formation at damage site.