Nerve regeneration through an epineurial sheath: Its functional aspect compared with nerve and vein grafts

• Published in: Microsurgery 2001, Vol.21 (5), p.196-201
• Main Authors: Karacaoğlu, Ercan, Yüksel, Fuat, Peker, Fatih, Güler, M. Mümtaz
• Format: Article
• Language: English
• Subjects: Animals; Biological and medical sciences; Cranial nerves. Peripheral nerves. Autonomic nervous system; Degeneration. Regeneration. Wound healing. Graft; Disease Models, Animal; Female; Fundamental and applied biological sciences. Psychology; Graft Rejection; Graft Survival; Jugular Veins - physiology; Jugular Veins - surgery; Male; Medical sciences; Microsurgery - methods; Nerve Regeneration - physiology; Neurosurgery; Peripheral Nerves - transplantation; Probability; Rats; Rats, Sprague-Dawley; Sciatic Nerve - physiology; Sciatic Nerve - surgery; Sensitivity and Specificity; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue Transplantation - methods; Tropical medicine; Vertebrates: anatomy and physiology, studies on body, several organs or systems
• ISSN: 0738-1085; 1098-2752
• DOI: 10.1002/micr.1038

Although nerve graft is still the only reliable choice in repair of defects in peripheral nerve structure, it has the disadvantage of donor nerve morbidity and of sometimes being unavailable. It has long been researched in alternate nerve grafts with other materials. Studies have shown that nerves could regenerate across short nerve gaps through various conduits, such as veins, pseudosheaths, and bioabsorbable tubes. Despite encouraging studies, their functional results remain unclear. The present study used 40 rats, in which nerve grafts, vein grafts, and epineurial tubes were placed into 1‐cm gaps in sciatic nerves created by resection. In one group, sciatic nerves were denuded of the surrounding epineurium, to assess the possible morbidity caused by epineurial sheath technique. At 2, 4, 8, 12, 20, and 28 weeks, functional assessment of nerve regeneration was performed using walking track analysis. The number of myelinated fibers and fiber diameters was measured and electron microscopic evaluation performed. Functionally, the index values were very close to each other in nerve graft and epineurial sheath groups. Morphometric analysis showed significance between the groups. The result of denuded sciatic nerve group was the same as the base track values. It was concluded that the ready availability of epineurial sheath as a conduit to span short nerve gaps could eliminate the morbidity associated with nerve graft harvest and capitalize on the potential benefits of neurotrophism in directing nerve regeneration. © 2001 Wiley‐Liss, Inc. Microsurgery 21:196–201 2001