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September 1966

Factors Influencing Nerve Repair: II. Collateral Circulation of Peripheral Nerves

Author Affiliations

From the departments of surgery (plastic) and anatomy, The New York Hospital-Cornell Medical Center, New York.

Arch Surg. 1966;93(3):433-437. doi:10.1001/archsurg.1966.01330030063014

THE IMPORTANCE of the local circulation to peripheral nerve function was considered in Part I *. Nerves have a mesoneurium which functions like the mesentery of the small intestine. This structure allows the nerve to move back and forth, yet gain a continuous supply of blood from the fixed, underlying bed. The blood passing through the mesoneurium is supplied to the nerve in a segmental fashion. The purpose of this study is to determine the adequacy of collateral circulation in those instances where some of the segmental circulation is no longer functioning.

Technique  Isolated segments of nerve were studied to determine the adequacy of collateral circulation through nutrient arteries located more proximally. In four upper extremities, "surgical procedures" were performed prior to instillation of the silicone rubber compound. In two instances the ulnar nerve was divided at the wrist level through a small stab incision. In two others, the median nerve

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