Critical resection length and gap distance in peripheral nerves

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The Second World War resulted in an unprecedented number of peripheral nerve injuries, prompting renewed research in neurosurgery. Advances in surgical techniques, particularly with the use of operating microscopes, have significantly contributed to this field. However, the context of wartime surgery differs greatly from peacetime practices. Rapid wound healing allows for secondary sutures to be performed around four weeks post-injury. In most cases, the extent of nerve damage is less severe than in wartime injuries, where the "critical resection length" (Seddon) posed significant challenges to successful outcomes. Surgeons during the war recognized that the specified dimensions for critical resection were often too large, leading them to attempt sutures even with considerable gaps between nerve ends. There was also a lack of precise information regarding direct damage to the axis cylinder or changes due to vascular factors when stretching nerves, especially during joint decompression mobilization. The author's experimental investigations may provide valuable insights into these issues. The meticulously executed and analyzed experiments are likely relevant to human conditions concerning total nerve length percentages.