title: The effects of adjuvant fibrin sealant on the surgical repair of segmental nerve defects in an animal model.
abstract: OBJECTIVE
  Nerve repair after a segmental defect injury remains a challenge for surgeons. Fibrin glue can be used to expedite surgical procedures and maintain proper nerve spatial orientation to potentially optimize recovery, yet surgeons hesitate to use it owing to concerns about fibrin's inhibiting regeneration and increasing scar formation. The purpose of these experiments was to evaluate whether fibrin glue impedes nerve regeneration.
  
  
  METHODS
  A critical-size defect of 10 mm was created in 32 Sprague-Dawley rats with 4 different forms of repair: a collagen type-I conduit (n = 8), a collagen type-I conduit filled with fibrin glue (n = 8), an autologous nerve graft (n=8), and an autologous nerve graft with fibrin glue (n = 8). Behavioral tests, including sciatic functional indices, were used to evaluate functional recovery. Neurophysiology, immunohistochemistry, and nerve morphometry were used to critically analyze nerve regeneration.
  
  
  RESULTS
  Multiple outcome parameters for nerve regeneration, remyelination, behavior, and electrophysiology were used to determine that the addition of fibrin did not influence recovery for the autograft groups. Similarly, within the conduit group, behavioral tests showed comparable functional recovery and indistinguishable results in compound motor action potential and nerve morphometry. Immunohistochemistry revealed identical degrees of Wallerian degeneration and scarring between conduit groups.
  
  
  CONCLUSIONS
  The addition of fibrin to either the conduit or the autograft group did not result in any meaningful differences in recovery. Our data demonstrate that fibrin glue does not impede nerve regeneration or functional recovery after surgical repair of a segmental nerve defect in a rat model.
  
  
  CONCLUSIONS
  The clinical use of fibrin glue as an adjunct with peripheral nerve repair may be considered safe because it does not impair nerve regeneration with critical size defects in an animal model.
authors.affiliation: Department of Orthopaedic Surgery, University of California, Irvine, CA, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: Rafijah
authors.forename: Andrew Jay
authors.initials: AJ
authors.lastname: Bowen
authors.forename: Christina
authors.initials: C
authors.lastname: Dolores
authors.forename: Ryan
authors.initials: R
authors.lastname: Vitali
authors.forename: Tahseen
authors.initials: T
authors.lastname: Mozaffar
authors.forename: Ranjan
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000818:Animals; D003094:Collagen / Q000494:pharmacology; D019299:Decompression, Surgical; D005260:Female; D015718:Fibrin Tissue Adhesive / Q000008:administration & dosage*; D007150:Immunohistochemistry; D008297:Male; D009048:Motor Skills; D009416:Nerve Regeneration / Q000187:drug effects; D059348:Peripheral Nerve Injuries / Q000473:pathology / Q000601:surgery; D051381:Rats; D017207:Rats, Sprague-Dawley; D019651:Plastic Surgery Procedures / Q000379:methods; D020127:Recovery of Function; D012584:Sciatic Nerve / Q000293:injuries / Q000473:pathology / Q000601:surgery; D013536:Suture Techniques; D014014:Tissue Adhesives / Q000008:administration & dosage*; D054457:Tissue Scaffolds; D014855:Wallerian Degeneration / Q000188:drug therapy; D014945:Wound Healing / Q000502:physiology
chemical_list: D015718:Fibrin Tissue Adhesive; D014014:Tissue Adhesives; D003094:Collagen