Local tissue reactions after nerve repair with ethyl-cyanoacrylate compared with epineural sutures

Abstract

Anastomosis of a nerve with cyanoacrylate following a lesion has previously been shown to indicate morphological and functional recovery to an extent comparable to that of conventional epineural sutures. In this study we examined the local tissue reactions after transection and repair of rat sciatic nerve, and compared sutures with a synthetic ethyl-cyanoacrylate adhesive. Many ED-1-immunoreactive macrophages were found accumulating on either side of the repair site whereas neurofilament labelling was less pronounced distal to the repair site seven days after reparation with cyanoacrylate compared with sutures. After six months, when reinnervation was completed, the difference in ED-1-immunoreactivity was still present but to a less extent. These results indicate that ethyl-cyanoacrylate seems to induce an increased inflammatory reaction, which may lead to accelerated Wallerian degeneration, and could therefore have benefits over conventional sutures for reconstruction of peripheral nerves.

Cyanoacrylate in nerve repair: transient cytotoxic effect

“…Proximal to the seam, no evident differences between the two repair methods with respect to the number or distribution of neurofilaments could be seen. These findings, in combination with observations of nerve regeneration, starting in the proximal stump, with path-finding axons beginning to penetrate the ECA barrier, indicated that no acute axonal degeneration caused by the adhesive had taken place proximal to the seam 17 . In a parallel study, the authors demonstrated an improved motor, and a comparable sensory, recovery after experimental repair of a transected peripheral nerve with synthetic adhesive in comparison with microsutures 16 .…”

Nerve repair: toward a sutureless approach

“…A number of rat studies compared cyanoacrylate against the direct suture method on sciatic nerves and found no difference with regard to regeneration or functional outcome; however, the cyanoacrylate was simpler, although more time consuming (glue setting) [12,31,32]. A concern that has been frequently reported is the compression of regenerating nerve fibres when cyanoacrylate sets [32], along with its limited flexibility. However, this can be avoided, by overlapping the adjacent epineural sheaths and using minimal amounts of glue (Fig.…”

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

“…Cyanoacrylates are especially attractive due to their mechanical strength and fast cure times 5. While some studies have investigated the chronic tissue reaction and bonding of cyanoacrylates,4, 6 the short‐term consequences of cyanoacrylates on nerve tissue have not been thoroughly evaluated. Therefore, the present study attempts to address the acute effects of ethyl‐ cyanoacrylate (CA) on the functional and structural properties of repaired nerves.…”