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de la eliminación de la tensión mediante puntos epineurales: Estudio comparativo empleando diferentes técnicas de sutura en un modelo animal

Keywords: neuroraphy, tension, autologous graft, nerve suture.

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Abstract:

objective. to measure the utility of this technique, in comparison with interposed grafts and termino-terminal neuroraphy, all applied in an experimental model (wistar rat). materials and method. 20 rats were used in both sides (40 legs, each one considered as independent physiological units, were grouped in four groups: in the first one, a section of the sciatic nerve was performed, a segment 4mm long was discarded and an epineural suture with distal anchoring stitches was done under slight tension. in the second group a tensionless termino-terminal neuroraphy was performed after sciatic nerve section. in the third group a 4 mm long graft was employed and the fourth was used as control. 90 days after this procedure, the animals were reoperated and muscle and nerve action potentials were recorded in both sides. results. the mean conduction velocity for the simple suture was higher than the other two groups, but lower than the control (19,31 mm/ms). neuroraphy with epineural stitches (12,02 mm/ms) was better than when an autologous nerve graft was employed (11,09 mm/ms). conclusion. this study demonstrates that a good result can be obtained if a nerve is sutured under slight tension, employing epineural anchoring stitches. nevertheless, more studies should be performed before applying these results to human nerve suture.

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