Glued Nerves

A possible solution to the military surgeon's problem of regenerating severed nerves was suggested last week by Dr. Nilson de Rezende of Rio de Janeiro in the New York State Journal of Medicine. His method: transplantation of nerves from cadavers, and the use of glue instead of stitches to hold the grafts in place. Destruction of sections of the peripheral nerves (those near the surface of the skin) is rare in civil life, says Dr. de Rezende, but it occurred in 3,500 of the 200,000 U.S. casualties in World War I.

During the last 50 years doctors have found it almost impossible to repair nerves which have been cut, especially when a section of nerve has been torn away. Chief difficulty has been to bind the severed nerve ends or grafts together: even the finest needles and threads (e.g., blood vessel sutures) lacerate the nerve bundles. Researchers at Oxford in 1940 discarded stitching and used a glue made of chick plasma to bind severed nerves together.

At Yale's Laboratory of Physiology, Dr. de Rezende developed a simpler glue: a solution of gum acacia (fortified with vitamin B). But despite this glue, he noted that a severed nerve tends to retract both ways so that connection of the ends is still difficult. This tension can be avoided, Dr. de Rezende found, by inserting a nerve graft between the severed ends. On the legs of monkeys, rabbits and dogs he performed some 60 nerve-grafting operations, taking his grafts from dead animals of the same species. Nearly half his operations he termed successful: the animals regained good use of their limbs.

Nerve grafts from cadavers can be preserved for long periods, Dr. de Rezende found, in either liquid petrolatum or alcohol. The grafted nerve tissue need not be "alive" when transplanted. Reason: "The function of the nerve transplant is to a large extent merely mechanical. The graft presents thousands of microscopic channels which will help the down-growth of the neurofibrils."

Dr. de Rezende admits that surgery of human nerves is unlike experiments on animals because the wound is often infected. But he believes that new drugs such as the sulfonamides and gramicidin (TIME, Nov. 17, 1941) will decrease this difficulty and should make grafting and gluing of nerves possible in the military surgery of World War II.

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