Evidence brief
Peripheral Nerve Repair Principles
Tension-free repair essential
Primary repair preferred when possible
Nerve regeneration ~1mm/day
Proximal injuries have better outcomes
Nerve grafting for gaps >3-4cm
Fundamental principles of nerve repair guide management of traumatic nerve injuries. Tension-free coaptation with proper alignment is critical for optimal regeneration.
Classic teaching: repair without tension, epineural vs grouped fascicular repair, timing (primary if possible, delayed if contaminated). Know Sunderland classification. Regeneration rate 1mm/day. Calculate expected recovery time. Discuss conduits and grafts for gaps.
Mackinnon SE, Dellon AL. Surgery of the Peripheral Nerve. New York: Thieme; 1988.
Level V
Expert opinion or mechanism-based reasoning