Is early vascularization of nerve grafts necessary?

Revascularization and regeneration through vascularized and non-vascularized nerve grafts were compared on optimal and adverse graft beds in 76 rabbit sciatic nerves. A delay in revascularization of more than 14 days was found to occur in 30 mm long, non-vascularized nerve grafts placed on completely avascular graft graft beds. However, over a period of 44 weeks, this prolonged ischaemia did not adversely affect nerve regeneration. The vascularized nerve grafts did not differ significantly with respect to the rate of regeneration, motor conduction velocity, fibre diameter and thickness of myelin sheath. In rabbits, the provision of early vascularity does not appear to confer superior regeneration through nerve grafts. The clinical use of vascularized nerve grafts is discussed in the light of these results.