Ethyl‐cyanoacrylate is acutely nontoxic and provides sufficient bond strength for anastomosis of peripheral nerves

Rickett, Todd; Li, Jianming; Patel, Meenal; Sun, Wenjing; Leung, Gary N. W.; Shi, Riyi

doi:10.1002/jbm.a.32137

Cited by 17 publications

(13 citation statements)

References 14 publications

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“…However, this can be avoided, by overlapping the adjacent epineural sheaths and using minimal amounts of glue (Fig. 1f) [12,72]. Choi et al reported that applying the cyanoacrylate glue in micro-drops to the outer epineurium on rat sciatic nerves reduced the compression effects, while providing adequate tensile strength to the nerve ends [12].…”

Section: Gluesmentioning

confidence: 97%

Nerve repair: toward a sutureless approach

et al. 2014

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Peripheral nerve repair for complete section injuries employ reconstructive techniques that invariably require sutures in their application. Sutures are unable to seal the nerve, thus incapable of preventing leakage of important intraneural fluids from the regenerating nerve. Furthermore, sutures are technically demanding to apply for direct repairs and often induce detrimental scarring that impedes healing and functional recovery. To overcome these limitations, biocompatible and biodegradable glues have been used to seal and repair peripheral nerves. Although creating a sufficient seal, they can lack flexibility and present infection risks or cytotoxicity. Other adhesive biomaterials have recently emerged into practice that are usually based on proteins such as albumin and collagen or polysaccharides like chitosan. These adhesives form their union to nerve tissue by either photothermal (tissue welding) or photochemical (tissue bonding) activation with laser light. These biomaterial adhesives offer significant advantages over sutures, such as their capacity to unite and seal the epineurium, ease of application, reduced invasiveness and add the potential for drug delivery in situ to facilitate regeneration. This paper reviews a number of different peripheral nerve repair (or reconstructive) techniques currently used clinically and in experimental procedures for nerve injuries with or without tissue deficit.

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Section: Gluesmentioning

confidence: 97%

Nerve repair: toward a sutureless approach

et al. 2014

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“…[19, 20] Interfacial strength of the tissue-adhesive specimens (Figs. 2a-b) was assessed by applying a constant displacement rate (0.05mm/s) normal to the tissue-adhesive-tissue interface (see Materials and Methods).…”

Section: Resultsmentioning

confidence: 99%

Tuning adhesion failure strength for tissue-specific applications

et al. 2011

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Soft tissue adhesives are employed to repair and seal multiple organs, which range in both tissue surface chemistry and mechanical challenges during organ function. This complexity motivates the development of tunable adhesive materials with high resistance to uniaxial or multiaxial loads dictated by a specific organ environment. Co-polymeric hydrogels comprising aminated star polyethylene glycol and dextran aldehyde (PEG:dextran) are materials exhibiting physicochemical properties that can be modified to achieve this organ-and tissue-specific adhesion performance. Here we report that resistance to failure under specific loading conditions, as well as tissue response at the adhesive material-tissue interface, can be modulated through regulation of number and density of adhesive aldehyde groups. We find that atomic force microscopy (AFM) can characterize material aldehyde density available for tissue interaction, and in this way enable rapid, informed material choice. Further, the correlation between AFM quantification of nanoscale unbinding forces with macroscale measurements of adhesion strength by uniaxial tension or multiaxial burst pressure allows for the design of materials with specific cohesion and adhesion strengths. However, failure strength alone does not predict optimal in vivo reactivity. Thus, we demonstrate that the development of adhesive materials is enabled significantly when experiments are integrated along lengthscales to consider organ chemistry and mechanical loading states concurrently with adhesive material properties and tissue response.

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“…These results support the findings published in the literature, that cyanoacrylate glues can be used in direct contact with the nerve. [42][43][44][45][46] A dedicated experimentation is running to study the possible effect produced by a direct contact, inside the regeneration chamber, between the acrylate glue and the tiny regenerating axons and the associated Schwann's cells, even if this assembly is not expected to be ever encountered in a properly surgically implanted NeuroBox.…”

Section: Discussionmentioning

confidence: 99%

In vivo regeneration of rat sciatic nerve in a double‐halved stitch‐less guide: A pilot‐study

et al. 2009

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It is about 20 years that tubular nerve guides have been introduced into clinical practice as a reliable alternative to autograft, in gaps not-longer-than 20 mm, bringing the advantage of avoiding donor site sacrifice and morbidity. There are limitations in the application of tubular guides. First, tubular structure in itself makes surgical implantation difficult; second, stitch sutures required to secure the guide may represent a site of unfavorable fibroblastic reaction; third, maximum length and diameter of the guide correlate with the occurrence of a poorer central vascularization of regenerated nerve. We report on the in vivo testing of a new concept of nerve-guide (named NeuroBox) which is double-halved, not-degradable, rigid, and does not require any stitch to be held in place, employing acrylate glue instead. Five male Wistar rats had the new guide implanted in a 4-mm sciatic nerve defect; two guides incorporated a surface constituted of microtrenches aligned longitudinally. Further five rats had the 4-mm gap left without repair. Contralateral intact nerves were used as controls. After 2 months, nerve regeneration occurred in all animals treated by the NeuroBox; fine blood vessels were well represented. There was no regeneration in the un-treated animals. Even if the limited number of animals does not allow to draw definitive conclusions, some result can be highlighted: an easy surgical technique was associated with the box-shaped guide and acrylate glue was easily applied; an adequate intraneural vascularization was found concurrently with the regeneration of the nerve and no adverse fibroblastic proliferation was present.

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Ethyl‐cyanoacrylate is acutely nontoxic and provides sufficient bond strength for anastomosis of peripheral nerves

Cited by 17 publications

References 14 publications

Nerve repair: toward a sutureless approach

Nerve repair: toward a sutureless approach

Tuning adhesion failure strength for tissue-specific applications

In vivo regeneration of rat sciatic nerve in a double‐halved stitch‐less guide: A pilot‐study

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