Nerve anastomoses with human fibrin. Preliminary clinical report (56 cases).
Since 1980, 56 peripheral nerve repairs have been done with fibrin. For technical reasons, combined anastomoses have been chosen in brachial plexus repairs (23 cases), fibrin alone being used in most other cases (8 free flaps, 17 main trunks, 8 digital nerves). As a whole, results compare evenly with the so-called classical repair methods using stitches. The adhesive method's main advantage is the gain in operative time, without impairing precision. Secondary benefits, such as hemostasis and easier stabilization of small grafts, can be achieved. One question remains: what becomes of fibrin? The survey of present cases would tend to prove that axonal growth through the second anastomosis is impeded proportionally to the length of the graft. The possible action of fibrin in the alteration process leading to a sclerotic diaphragm is not elucidated to this day. Experimental as well as clinical research must be carried on, in order to improve this new way of repairing nerves.
Egloff
D V
DV
Service de Chirurgie Plastique et Reconstructrice, Clinique de Longeraie, Lausanne, Suisse.
Narakas
A
A
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000714:Anastomosis, Surgical / Q000379:methods; D001369:Axons / Q000502:physiology / Q000637:transplantation; D001917:Brachial Plexus / Q000601:surgery; D002648:Child; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D005385:Fingers / Q000294:innervation; D006488:Hemostasis, Surgical; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D009416:Nerve Regeneration; D016067:Nerve Transfer / Q000379:methods; D010525:Peripheral Nerves / Q000473:pathology / Q000601:surgery* / Q000637:transplantation; D012598:Sclerosis; D012677:Sensation / Q000502:physiology; D013524:Surgical Flaps; D013536:Suture Techniques; D013997:Time Factors; D014014:Tissue Adhesives / Q000627:therapeutic use*; D016896:Treatment Outcome
D015718:Fibrin Tissue Adhesive; D006490:Hemostatics; D014014:Tissue Adhesives