title: Epimysium and perimysium in suturing in skeletal muscle lacerations.
abstract: BACKGROUND
  Direct muscle belly trauma is common. Selecting optimal methods for surgical repair of muscle disruption is difficult because reliable methods have not been established. Suturing tendon offers strong repairs, but epimysium and perimysium, the connective tissues that coalesce to form tendons, offer unknown repair strength. The purpose of this study was to compare biomechanical properties of repaired muscle in transected muscle bellies with epimysium and perimysium.
  
  
  METHODS
  The authors surgically repaired with figure-eight stitches in both epimysium and perimysium groups. Individual stitches were placed in lacerated quadriceps bellies from a euthanized pig and were tensioned on a biomechanical machine. Maximum loads and strains were measured, and failure mechanisms were recorded.
  
  
  RESULTS
  Loads and strains for repairs with epimysium were higher than those for repairs with perimysium. Failure mechanisms were significantly different between groups.
  
  
  CONCLUSIONS
  These data showed that epimysium incorporation into suturing improves capacity to bear forces compared with perimysium incorporation.
authors.affiliation: Orthopaedic Service, Brooke Army Medical Center, Fort Sam Houston, Texas 78234-6200, USA. john.kragh@amedd.army.mil
authors.forename: John F
authors.initials: JF
authors.lastname: Kragh
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Svoboda
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Wenke
authors.forename: John A
authors.initials: JA
authors.lastname: Ward
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Walters
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D005206:Fascia Lata / Q000601:surgery; D005260:Female; D022125:Lacerations / Q000601:surgery*; D008422:Materials Testing; D018482:Muscle, Skeletal / Q000293:injuries* / Q000503:physiopathology / Q000601:surgery*; D013536:Suture Techniques; D013552:Swine; D013718:Tensile Strength / Q000502:physiology