The Cutting Edge: Surface Texture Analysis following Resection of Nerve Stumps Using Various Instruments

Area of Science:

• Microsurgery
• Biomaterials Science
• Surgical Techniques

Background:

• Nerve end preparation is critical for successful nerve repair surgery.
• Optimal surgical instruments for minimizing nerve trauma remain debated.
• Different excision techniques may impact nerve end surface topography.

Purpose of the Study:

• To compare the surface roughness of nerve ends prepared with different surgical instruments.
• To evaluate the impact of No. 11 blade, razor blade, and scissors on nerve end topography.
• To identify the least traumatic instrument for nerve end preparation in surgical repair.

Main Methods:

• Cadaveric median and ulnar nerves were dissected and excised using a No. 11 blade, razor blade, or scissors.
• Three-dimensional surface roughness analysis (Sa) was performed using electron microscopy (ZeeScan, PhaseView).
• Statistical analysis (ANOVA, Kruskal-Wallis) compared roughness metrics across cutting techniques.

Main Results:

• Scissors yielded the smoothest surface (Sa: 7.2 µM), followed closely by the No. 11 blade (7.29 µM).
• Razor blade excision resulted in significantly higher surface roughness (Sa: 11.03 µM).
• Surface profile roughness (Ra) was lowest with the No. 11 blade (3 µM), followed by scissors (3.29 µM), and razor blade (5.41 µM).

Conclusions:

• Razor blade use is associated with poor nerve end surface roughness.
• No. 11 blades and nerve-specific scissors produce comparably smooth nerve ends.
• These findings inform instrument selection for less traumatic nerve repair surgery.