title: Effects of eliminating tension by means of epineural stitches: a comparative electrophysiological and histomorphometrical study using different suture techniques in an animal model.
abstract: Epineural stitches are a means to avoid tension in a nerve suture. We evaluate this technique, relative to interposed grafts and simple neurorraphy, in a rat model.
  
  
  METHODS
  Twenty rats were allocated to four groups. For Group 1, sectioning of the sciatic nerve was performed, a segment 4 mm long discarded, and epineural suture with distal anchoring stitches were placed resulting in slight tension neurorraphy. For Group 2, a simple neurorraphy was performed. For Group 3, a 4 mm long graft was employed and Group 4 served as control. Ninety days after, reoperation, latency of motor action potentials recording and axonal counts were performed. Inter-group comparison was done by means of ANOVA and the non-parametric Kruskal-Wallis test.
  
  
  RESULTS
  The mean motor latency for the simple suture (2.27±0.77 ms) was lower than for the other two surgical groups, but lower than among controls (1.69±0.56 ms). Similar values were founding in both group 1 (2.66±0.71 ms) and group 3 (2.64±0.6 ms). When fibers diameters were compared a significant difference was identified between groups 2 and 3 (p=0.048).
  
  
  CONCLUSIONS
  Good results can be obtained when suturing a nerve employ with epineural anchoring stitches. However, more studies are needed before extrapolating results to human nerve sutures.
authors.affiliation: School of Medical Sciences Laboratory of the Program of Organ and Tissue Transplants, National University of La Plata, Argentina.
authors.forename: Jorge
authors.initials: J
authors.lastname: Bustamante
authors.forename: Mariano
authors.initials: M
authors.lastname: Socolovsky
authors.forename: Roberto S
authors.initials: RS
authors.lastname: Martins
authors.forename: Juan
authors.initials: J
authors.lastname: Emmerich
authors.forename: Maria Gabriela
authors.initials: MG
authors.lastname: Pennini
authors.forename: Natalia
authors.initials: N
authors.lastname: Lausada
authors.forename: Luis
authors.initials: L
authors.lastname: Domitrovic
mesh_terms: D000818:Animals; D001369:Axons / Q000473:pathology / Q000502:physiology; D004594:Electrophysiology; D008297:Male; D023421:Models, Animal; D009416:Nerve Regeneration / Q000502:physiology*; D010525:Peripheral Nerves / Q000601:surgery*; D011897:Random Allocation; D051381:Rats; D013536:Suture Techniques; D013718:Tensile Strength