Research Article

The Proximal Medial Sural Nerve Biopsy Model: A Standardised and Reproducible Baseline Clinical Model for the Translational Evaluation of Bioengineered Nerve Guides

Figure 4

Operative technique (Part II). Gap between the proximal and distal nerve stumps resulting from excision of a 2 cm nerve biopsy (a). Please note that the resulting nerve gap (approximately 3 cm) is larger than the length of the nerve biopsy (approximately 2 cm) due to the elastic retraction of the nerve stumps. Implantation of the nerve guide using the entubulization technique by means of 8.0 mattress sutures. Note the start of the mattress suture at the side of the nerve guide, positioning the knot on the nerve guide with the following sequence of needle penetration: 1 Neuromaix → 2 epineurium → 3 epineurium →4 Neuromaix (b)-(c). After completion of the entubulization procedure, the implanted nerve guide is located in its wound bed between the medial and lateral heads of the gastrocnemius muscle (d). Wound closure in anatomic layers (e) after insertion of a minivacuum drainage system (f).
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(a)
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(b)
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(c)
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(d)
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(e)
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(f)