Epimysium and perimysium in suturing in skeletal muscle lacerations

Background: Direct muscle belly trauma is common. Selecting optimal methods for surgical repair of muscle disruption is difficult because reliable methods have not been established. Suturing tendon offers strong repairs, but epimysium and perimysium, the connective tissues that coalesce to form tendons, offer unknown repair strength. The purpose of this study was to compare biomechanical properties of repaired muscle in transected muscle bellies with epimysium and perimysium. Methods: The authors surgically repaired with figure-eight stitches in both epimysium and perimysium groups. Individual stitches were placed in lacerated quadriceps bellies from a euthanized pig and were tensioned on a biomechanical machine. Maximum loads and strains were measured, and failure mechanisms were recorded. Results: Loads and strains for repairs with epimysium were higher than those for repairs with perimysium. Failure mechanisms were significantly different between groups. Conclusion: These data showed that epimysium incorporation into suturing improves capacity to bear forces compared with perimysium incorporation.