Nerve Anastomosis with Glue: Comparative Histologic Study of Fibrin and Cyanoacrylate Glue

Abstract

The authors report the results of a comparative experimental nerve study, using a biologic tissue glue (fibrin) and a synthetic glue (2-cyanoacrylate) in a rat model. A tension-free repair is necessary with the use of fibrin glue, or gapping may occur, thus limiting the use of the agent in promoting re-neurotization. In addition, the human origin of fibrin and thrombin allow for the possibility of viral transmission. The aim of the study was to verify if the synthetic glue is a viable alternative, or whether it causes cellular and tissue lesions. Their main finding was that the cyanoacrylate causes a foreign-body inflammatory reaction and retractile fibrosis, often reducing the nerve diameter up to two-thirds. Cyanoacrylate glue is thus not recommended for peripheral nerve repair.

Anastomose do nervo facial de coelhos com cola de fibrina: estudo da velocidade de condução nervosa

“…Fibrin glue is permeable and remains in place for the necessary time to allow nerve stump union 32,33 . Young and Medawar 34 introduced this material as an alternative to conventional nerve suturing.…”

“…Among existing adhesive we may stress the cyanoacrylates. However, they induce fibrosis and foreign body reaction, thus not being recommended for nerve anastomosis 33 . In order to assess nerve anastomosis with the fibrin glue in the present study we carried out functional and histology analyses.…”

Histopathological Effects of Fibrin Glue and Cyanoacrylate on the Maxillary Sinus

“…However, FbGl was preferred because CyAc was associated with significantly higher levels of inflammation and elevated wound temperatures in the early stages of healing. Wieken et al (24) compared FbGl and CyAc in the context of neural anastomosis in a rat model. CyAc caused inflammation, reminiscent of a foreign body reaction, and decrease in the neural diameter by 66%.…”

The clinical study of repairing cauda equina fibres with fibrin glue after lumbar fracture and dislocation

“…In view of the poor neurological recovery with both of the above-mentioned approaches, particularly in complete injuries, attempt was made by the authors to find a better method of anastomosis to improve outcome. As fibrin glue has been approved by US Food and Drug Administration and used successfully in repairing cranial nerves and other tissues clinically, 6,7 we decided to use it to join the torn ends of nerve roots of cauda equina with the hope of improving the outcome of anastomoses and hence neurological recovery. The study results constitute the content of this report.…”