Use of the turnover epineurial sheath tube for repair of peripheral nerve gaps

Autologous nerve grafting is the conventional technique for bridging nerve gaps, despite its various disadvantages. In this study, the authors investi gated the effects of the turnover epineurial sheath tube (TEST) as an alter native to nerve grafting for the repair of nerve gaps, using a rat sciatic nerve model in four groups: Group 1 (n = 5): sham control; Group 2 (n = 10) : segmental nerve resection + no repair; Group 3 (n = 10): segmental nerve resection + nerve grafting; Group 4 (n = 15): segmental nerve resection + T EST. Functional recovery was evaluated by walking-track analysis. The sciat ic nerves and gastrocnemius muscles were harvested for histologic and quant itative histomorphometric evaluation at 12 weeks. Sciatic functional indice s and histomorphometric analyses revealed statistically significant differe nces between the sham control and the three experimental groups (p < 0.001) . The difference between the TEST group and the nerve graft group was not s ignificant; however functional recovery was significantly improved in these two groups, compared to the non-repaired group (p < 0.05). The authors sug gest that the TEST provides a suitable conduit between two stumps, eliminat es donor-site morbidity, reduces the number of suture sites, fibrosis, and operating time, and might be an alternative to nerve grafting for nerve gap repair.