Nerve Assessment Index: A New Rating Tool for Peripheral Nerve Coaptations in Sharp Nerve Transections

Peripheral nerve injuries represent a significant clinical challenge, often resulting in long-term sensory and motor deficits, disability, and reduced quality of life. Despite advances in microsurgical techniques and regenerative medicine, the functional outcomes following nerve repair remain highly variable and unpredictable. One critical factor influencing success is the quality of the initial nerve coaptation. Currently, there is no standardized, objective tool for assessing the quality of nerve coaptation during surgery. This lack of uniform assessment criteria hinders meaningful comparison between surgical techniques and limits the reproducibility of experimental and clinical studies. To address this gap, we proposed the development of a novel rating system-the "Nerve Assessment Index"-designed to evaluate the anatomical and morphological quality of nerve coaptation. By providing a structured, reproducible framework for scoring nerve repairs, the Nerve Assessment Index aims to harmonize reporting standards in both clinical and preclinical settings, improve intraoperative decision-making, and facilitate more robust comparisons across studies. Ultimately, this tool may promote more consistency, transparency, and higher quality evidence in peripheral nerve surgery.