title: Fibrin glue mitigates the learning curve of microneurosurgical repair.
abstract: Microneurosurgical technique has a steep learning curve. An alternative to microepineurial suture repair of peripheral nerves that circumvents this learning curve would be ideal. We investigated the effect of surgeon experience on suture versus fibrin glue coaptations in a mouse sciatic nerve graft model. Sixty-four mice received sciatic nerve grafts with either suture or fibrin glue repair by either a naïve surgeon (medical student) or a surgeon with extensive microsurgical experience. Grafts underwent quantitative histomorphometry at 3 weeks postoperatively. Suture repairs performed by the naïve surgeon demonstrated significantly poorer distal regeneration than all other repairs. Histomorphometric parameters of suture and glue repairs performed by the experienced surgeon were not significantly different from the glue coaptation by the naïve surgeon. Fibrin glue may be considered as an alternative to microepineurial suture repair, particularly in the setting of relative surgeon inexperience with microsurgical technique.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Whitlock
authors.forename: Rahul
authors.initials: R
authors.lastname: Kasukurthi
authors.forename: Ying
authors.initials: Y
authors.lastname: Yan
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Tung
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hunter
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D015718:Fibrin Tissue Adhesive / Q000627:therapeutic use*; D051379:Mice; D008807:Mice, Inbred BALB C; D008866:Microsurgery; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D012584:Sciatic Nerve / Q000293:injuries / Q000601:surgery / Q000637:transplantation*; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000627:therapeutic use*
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives