The epineureal sleeve technique is designed to provide a cover and separate the site of nerve coaptation. The purpose of this study is to evaluate nerve recovery following epineural sleeve anastomosis technique for nerve graft reconstruction of the rat sciatic nerve. Animals were divided into three groups: conventional nerve grafting, epineural sleeve from recipient nerve stumps, and epineural sleeve from graft. Nerve regeneration was evaluated by pin-prick, toe-spread test, walking track analysis and somatosensory-evoked potentials, gastrocnemius index, and histomorphometric evaluation.
Most parameters showed significantly better nerve recovery for epineureal sleeve from the recipient nerve stumps when compared to the conventional nerve graft group. The authors conclude that epineural sleeve graft technique may be a promising method with potential application for nerve reconstructive procedures.
In successful nerve reconstruction, nerve coaptation is of utmost importance and thus proper surgical technique is essential. The epineureal sleeve technique was originally described in 1974 and is designed to prevent neuroma formation by providing nerve coaptation site fascicle coverage in an environment that is “friendly” for nerve regeneration. Based on these results, this technique of providing permissive microenvironment for nerve regeneration holds excellent promise. It will be interesting to compare the epinureal sleeve technique to coverage of nerve grafts with commercially available nerve conduits as the latter is certainly less technically challenging.