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Related Experiment Video

Updated: Apr 21, 2026

Three-dimensional Imaging and Analysis of Mitochondria within Human Intraepidermal Nerve Fibers
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Characterization of Trimmed Nerve Morphology Using High-Resolution Imaging: Comparison of Three Surgical Instruments.

Rasa Zhukauskas1, Brandon S Smetana2, Adam B Strohl3

  • 1Axogen Corporation, Alachua, FL.

Journal of Hand Surgery Global Online
|April 20, 2026
PubMed
Summary

Optimal nerve regeneration requires precisely trimmed nerve stumps. A neurotome provided the smoothest nerve ends, while a surgical blade improved preparation quality over microscissors for nerve repair.

Keywords:
Nerve cuttingNerve reconstructionNerve repairNerve trimmingNerve zone of injury

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Area of Science:

  • Microsurgery
  • Nerve Regeneration
  • Surgical Techniques

Background:

  • Successful nerve regeneration hinges on morphometrically matching proximal and distal nerve stumps.
  • Healthy fascicular tissue is crucial for potentiating nerve regeneration after injury or repair.

Purpose of the Study:

  • To investigate differences in nerve trimming instruments for optimal nerve repair.
  • To guide optimal nerve-trimming techniques by comparing surgical instruments.

Main Methods:

  • Three instruments (neurotome, scalpel, microscissors) trimmed human upper-extremity nerves.
  • Microcomputed tomography assessed intraneural damage length.
  • Cryoscanning electron microscopy evaluated fascicular distortion and surface roughness.

Main Results:

  • Intraneural damage length was similar across instruments in zone II.
  • Scalpel-trimmed nerves showed more variable damage length in zone V.
  • Scalpel and neurotome trimming resulted in less fascicular distortion and roughness than microscissors.

Conclusions:

  • Neurotome-trimmed nerves exhibited superior surface consistency and smoothness.
  • Surgical blade use enhances nerve preparation quality compared to microscissors.
  • Instrument choice significantly impacts nerve stump quality for regeneration.