The turnover distal epineurial sheath tube for repair of peripheral nerve gaps.

J Med Assoc Thai

Division of Plastic and Maxillofacial Surgery, Department of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Published: May 2006

Background And Objective: Autologous nerve grafting is the conventional technique for bridging nerve gaps. However, the drawback of this technique is the morbidity associated with the left over donor site. The purpose of the present study was to investigate the effects of the turnover distal epineurial sheath tube as an alternative to nerve grafting for the repair of nerve gaps.

Material And Method: The experimental model included 14 male Wistar rats. The left and right sciatic nerves were resected and the 14 left sciatic nerve gaps were reconstructed using conventional autologous nerve grafts while the other 14 right sciatic nerve gaps were reconstructed with turnover distal epineurial sheath tubes. All the repaired sciatic nerves were harvested for histologic and quantitative histomorphometric evaluation at the 11th week after the operations.

Results: There were no statistical differences in quantitative evaluation of Schwann cells between the conventional nerve grafting group and the distal epineurial sheath tube group (p > 0.05).

Conclusion: The turnover distal epineurial sheath tube provides a suitable conduit between two stumps, eliminates donor-site morbidity, reduces the operating time, and might be an alternative modality to nerve grafting for nerve gap repair.

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