Comparison between suture and fibrin glue on repair by direct coaptation or tubulization of injured mouse sciatic nerve

Félix, Severina P.; Marques, Suelen Adriani; Martínez, Ana Maria Blanco

doi:10.1002/micr.22109

Cited by 47 publications

(37 citation statements)

References 56 publications

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“…An important parameter confirming the functional improvement in our study was the g-ratio, which has been described as an index that reflects the optimal axonal myelination that leads to an appropriate conduction of action potentials (9). The g-ratio can simply be denoted as the ratio of axon circumference to myelin circumference, and this value will always be less than 1; however, remyelinated axons tend to have values closer to 1 than naturally myelinated axons.…”

Section: █ Discussionsupporting

confidence: 58%

Histomorphometric and ultrastructural evaluation of long term alpha lipoic acid and vitamin b12 use after experimental sciatic nerve injury in rats

Arıkan¹,

Toğral²,

Hastürk³

et al. 2015

Turkish Neurosurgery

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AIm: To analyze the therapeutic effects of long-term alpha lipoic acid (A-LA) and vitamin B12 use via histomorphometric methods and electron microscopy in the transected sciatic nerves of rats. mATERIAl and mEThODS: Forty rats were randomized into five groups (n=8/group). In group I, 1 cm segment of sciatic nerve was resected without any other intervention. In group II (sham), following right sciatic nerve transection, primary epineurial anastomosis was performed by placing the edges of the nerve end-to-end. In group III (saline), after right sciatic nerve transection, the ends of the nerves were brought together and closed after application of intraperitoneal physiologic saline. In group IV, 2 mg/kg of alpha lipoic acid and in group V, 2 mg/kg of vitamin B12 was administered intraperitoneally before surgical intervention. RESUlTS:Histomorphometric and electron microscopic analyses revealed that vitamin B12 did not prevent structural changes, abnormal myelination and g-ratio deviations regarding the functional aspects of the sciatic nerve. Alpha lipoic acid was more effective in restructuring the histomorphometric and structural aspects of the nerve with more myelinated fibers with optimal values (0.55-0.68) than vitamin B12 groups, in which the number of myelinated nerve fibers significantly decreased at optimal intervals (0.55-0.68).CONClUSION: A-LA administration following peripheral nerve transection injury is more effective in promoting nerve healing regarding the structural aspects of the sciatic nerve compared to vitamin B12 and also myelination of nerve fibers by increasing g-values.

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Section: █ Discussionsupporting

confidence: 58%

Histomorphometric and ultrastructural evaluation of long term alpha lipoic acid and vitamin b12 use after experimental sciatic nerve injury in rats

Arıkan¹,

Toğral²,

Hastürk³

et al. 2015

Turkish Neurosurgery

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“…In sectioned nerves, the first option of repair is the end-to-end neurorraphy, joining the stumps through suture or through adhesives (e.g fibrin glue) 7,16 . In some cases, according to the extension of the lesion, it is not possible unite the stumps and suture them without causing tension to the nerve, fact that occurs mainly when this rupture involves the loss of tissue.…”

Section: ■ Discussionmentioning

confidence: 99%

“…and not presenting autologous nerve graft morbidity in donor nerve removal, being able to regenerate the Sciatic nerve and thus the structures innervated 7,8 . This advantage was also reported by Demir et al 18 , who compared the use of the vein to that of a synthetic collagen tube in a 10 mm gap, and concluded that both, Tube of synthetic collagen and autologous vein grafts, produced similar results, however, with vein grafting being slightly more effective.…”

Section: ■ Discussionmentioning

confidence: 99%

“…Although this technique has a favorable result, it presents as main negative factors: the limitation of calibers, lengths and areas of donor nerves and secondary morbidity [6][7][8] . In this sense, the tubulization technique has been shown to be an appropriate and alternative method in clinical practice, which consists of the fixation of a tubular segment, which may be of biological or synthetic origin, between the stumps of the injured nerve, providing direction and favorable environment to regeneration 9,10 .…”

Section: ■ Introductionmentioning

confidence: 99%

“…In these cases the "gold standard" is autologous nerve graft, however, it has some disadvantages, such as loss of a healthy nerve, risk of neuromas formation, and limited availability of donor material 17 . Therefore, the use of autologous venous graft for nerve repair is a good option due to its low cost, non-rejection (even donor and recipient)and not presenting autologous nerve graft morbidity in donor nerve removal, being able to regenerate the Sciatic nerve and thus the structures innervated 7,8 . This advantage was also reported by Demir et al 18 , who compared the use of the vein to that of a synthetic collagen tube in a 10 mm gap, and concluded that both, Tube of synthetic collagen and autologous vein grafts, produced similar results, however, with vein grafting being slightly more effective.…”

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Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis

et al. 2017

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Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis 1 4-Experimental SurgeryActa Cir Bras. 2017;32(3):287-296 Abstract Purpose: To compare the functional result of standart vein grafts and inside-out vein graft technique on sciatic nerve repair. Methods: We used 24 male Wistar rats divided into 4 groups: control group (CG), standard vein graft group (SVG), Inside-out vein graft group (IOVG) and denervated Group (DG). SVG, IOVG and DG underwent total section of the sciatic nerve, SVG and IOVG however underwent nerve repair surgery using a graft with normal jugular vein and inside-out jugular vein, respectively. Histological analysis of the soleus and Extensor Digitorum Longus (EDL), and Sciatic Functional Index were used to compare the results after 6 weeks. Results: Both grafts acted favorably in muscle recovery and improved functionality; They were similar in all parameters, however, in more points SVG achieved similar to the CG, in the other hand IOVG more times was similar to DG. Fact that makes the graft with normal vein the most viable option between the two options. Conclusion: Both types of grafts acted beneficially wherein the graft normal vein has proved to be the best option 287Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis Bueno CRS et al. Acta Cir Bras. 2017;32(3):287-296 288 For this purpose, the adhesion of the rat as an animal model was based on the fact that its physiological profile, its morphological structure and the biological processes involved in the nerve regeneration are quite similar to that of the human being, being a suitable model for this investigation 14 . The purpose of this study was to compare the muscular and functional results after sciatic nerve repair with the tubulization technique using the normal vein graft and the reverse vein graft, in order to determine the most favorable surgical option. ■ MethodsThe study was approved under the protocol 032/2011 by the Ethics Committee, Faculty of Dentistry of Bauru, Universidade de São Paulo.Were used twenty-four male Wistar rats with 60 days of life in collective storage, with no restrictions on movement, respecting cycles of 12 hours of light / dark and average ambient temperature of 24°C. The animals were divided into four groups (n=6 each). Control Group (CG) and three experimental groups: Denervate Group (DG), Inside-Out Vein Graft (IOVG) and Standart Vein Graft (SVG). In all groups the right pelvic limb was used for the experimental study. The IOVG and SVG groups received autologous venous graft from the left jugular vein, but for the IOVG group, the jugular vein was inverted. Surgical proceduresThe animals were anesthetized with a combination of Ketamine Hydrochloride (Dopalen ® ) and Xilazine Hydrochloride (Anasedan ® ), administered intramuscularly at a dose of 0.10 ml/100g body weight in the dorsolateral region of the left hind paw. Subsequen...

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Nerve Repair With Fibrin Nerve Conduit and Modified Suture Placement

Wang

Degrugillier

Tremp

et al. 2018

The Anatomical Record

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Sutureless nerve repair has been regarded as a promising technique for nerve repair as the suture materials often results in neuroma formation and scar tissue that impede nerve regeneration. The aim of this study was to analyze the mechanical stability and morphological outcome of sutureless repair using fibrin glue conduit and an alternative approach of modified suture placement. Using rat sciatic nerve, we tested the following experimental conditions: conventional suture repair; single suture combined with fibrin glue repair, and fibrin conduit reinforced with modified suture or fibrin glue. Nerve detachment anatomical measures such as axon density, myelin, and fiber caliber were analyzed for evaluation of nerve regeneration. Muscle atrophy were evaluated by muscle wet weight and H&E staining. All animals in sutureless repair group exhibited complete detachment or elongation by two or four weeks after repair. No detachment was found in any other groups. Animals treated with fibrin conduit reinforced with modified suture showed better axonal regeneration with good alignment. There were no significant differences in axon caliber among the groups. Muscle atrophy was found in all groups and there was no significant difference in muscle wet-weight among the groups. In summary, sutureless nerve repair with fibrin glue was mechanically unstable for resistance of mechanical stretches, fibrin glue conduit with modified suture placement is mechanically stable and resulted in better morphological outcome.

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Comparison between suture and fibrin glue on repair by direct coaptation or tubulization of injured mouse sciatic nerve

Abstract: These results suggest that the use of fibrin glue in nerve repair by either direct coaptation or tubulization is an alternative to conventional suture repair, particularly in case of small-size-nerve reconstruction.

Cited by 47 publications

References 56 publications

Histomorphometric and ultrastructural evaluation of long term alpha lipoic acid and vitamin b12 use after experimental sciatic nerve injury in rats

Histomorphometric and ultrastructural evaluation of long term alpha lipoic acid and vitamin b12 use after experimental sciatic nerve injury in rats

Comparative study between standard and inside-out vein graft techniques on sciatic nerve repair of rats. Muscular and functional analysis

Nerve Repair With Fibrin Nerve Conduit and Modified Suture Placement

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