A systematic review on the use of fibrin glue for peripheral nerve repair.

Abstract:

BACKGROUND:Although Tisseel (Baxter, Deerfield, Ill.) was introduced over 30 years ago, the literature remains scant regarding its use and efficacy in peripheral nerve repairs. The goal of this systematic review was to summarize current literature on this topic and discuss differences in clinical outcome between the use of fibrin glue and conventional suturing methods for the repair of peripheral nerves. METHODS:A comprehensive electronic literature search was run in the following databases: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, and EMBASE. Articles were classified into three categories: animal, human, and cadaveric studies. RESULTS:Sixteen articles were included in the final analysis (kappa = 0.78). The most consistent outcome measure of the studies assessed was histopathology, which was evaluated in nine of 16 studies. This was followed closely by biomechanics, which were evaluated in eight of 16 studies. Histopathological studies demonstrated less significant granulomatous inflammation in the fibrin groups as well as better overall axonal regeneration, fiber alignment, and recovery of nerve conduction velocities. Animal and cadaveric studies demonstrated no significant differences in stiffness and peak load at failure between microsuture and fibrin groups. CONCLUSIONS:Although the majority of the reviewed studies employed animal models, most indicated that the performance of fibrin glue was equal, if not superior, to that of microsuturing when repairing peripheral nerves. Overall, many authors reported that fibrin glue was a quicker and easier modality to use than microsuture repair. There is, however, not a single well-controlled human trial assessing the efficacy of fibrin glue in relation to that of suturing techniques.

journal_name

Plast Reconstr Surg

authors

Sameem M,Wood TJ,Bain JR

doi

10.1097/PRS.0b013e3182131cf5

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

2381-2390

issue

6

eissn

0032-1052

issn

1529-4242

pii

00006534-201106000-00029

journal_volume

127

pub_type

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