A New Fibrin Seal in Primary Repair of Peripheral Nerves

Povlsen, Bo

doi:10.1016/0266-7681(94)90048-5

Cited by 28 publications

(23 citation statements)

References 11 publications

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“…For fibrin to promote more axons to regenerate longer distances, the fibrin must bind to and interact with neurotrophic factors such as nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), GDNF, NT-3, and PDGF [224,[231][232][233][234][235][236]. These platelet-and mesenchymal stem cellreleased factors transform pure fibrin from a 3-dimensional matrix that passively permits axon regeneration to one that actively promotes axon regeneration [237].…”

Section: Clinical: Improvementmentioning

confidence: 99%

Platelet-Rich Plasma Promotes Axon Regeneration, Wound Healing, and Pain Reduction: Fact or Fiction

Kuffler

2015

Mol Neurobiol

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Platelet-rich plasma (PRP) has been tested in vitro, in animal models, and clinically for its efficacy in enhancing the rate of wound healing, reducing pain associated with injuries, and promoting axon regeneration. Although extensive data indicate that PRP-released factors induce these effects, the claims are often weakened because many studies were not rigorous or controlled, the data were limited, and other studies yielded contrary results. Critical to assessing whether PRP is effective are the large number of variables in these studies, including the method of PRP preparation, which influences the composition of PRP; type of application; type of wounds; target tissues; and diverse animal models and clinical studies. All these variables raise the question of whether one can anticipate consistent influences and raise the possibility that most of the results are correct under the circumstances where PRP was tested. This review examines evidence on the potential influences of PRP and whether PRP-released factors could induce the reported influences and concludes that the preponderance of evidence suggests that PRP has the capacity to induce all the claimed influences, although this position cannot be definitively argued. Well-defined and rigorously controlled studies of the potential influences of PRP are required in which PRP is isolated and applied using consistent techniques, protocols, and models. Finally, it is concluded that, because of the purported benefits of PRP administration and the lack of adverse events, further animal and clinical studies should be performed to explore the potential influences of PRP.

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Section: Clinical: Improvementmentioning

confidence: 99%

Platelet-Rich Plasma Promotes Axon Regeneration, Wound Healing, and Pain Reduction: Fact or Fiction

Kuffler

2015

Mol Neurobiol

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“…Although direct suturing of the nerve is considered the standard procedure, it can be difficult due to reduced nerve caliber and sometimes can cause inflammatory reaction impairing the axonal re g e n e r a t i o n 1 . The repair with fibrin glue is an alternative to the conventional suture technique, although there is no definitive experimental evaluation of the two techniques [1][2][3][4][5][6][7][8][9][10][11][12][13] . In this study we compared the parameters obtained in the electrophysiologic evaluation in thre e d i ff e rent repairs techniques after the section of the rat sciatic nerve, trying to define which one allows better nerve regeneration.…”

mentioning

confidence: 99%

Electrophysiologic assessment of regeneration in rat sciatic nerve repair using suture, fibrin glue or a combination of both techniques

Martins

Siqueira

Silva

et al. 2005

Arq. Neuro-Psiquiatr.

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-We evaluated the repair of seccioned rat sciatic nerve by the comparison of electro p h y s i o l o gic parameters. The repair was effected with suture (group A), fibrin glue (group B) or a combination of both techniques (group C). The amplitude, latency and conduction velocity of the motor and nerve action potentials were assessed before the nerve section and at reoperation after 24 weeks. There was no diff e rence between the groups when the nerve action potential was evaluated. Rats of group B presented better results than those of group A (p<0.05) when latency and the nerve conduction velocity assessed at the reoperation, and the ratio between the conduction velocity at the reoperation and before the nerve section in the motor action potential evaluation were measured. Animals of group C presented better re s u l t s than those of group A when the ratio between the conduction velocity of motor action potential at the reoperation and before the nerve division was considered (p<0.05). No difference between groups B and C was found. We conclude that repair using fibrin glue presented better results than suture following t r a nsection of sciatic nerve when the motor action potential was evaluated in the rat experimental model. KEY WORDS: fibrin glue, nerve regeneration, suture, sciatic rat nerve.Avaliação eletrofisiológica da eficácia de três tipos de re p a ro após a secção do nervo ciático do rato RESUMO -Foram comparados os parâmetros obtidos na avaliação eletrofisiológica do potencial de ação do nervo e do potencial de ação motor antes e após 24 semanas do re p a ro no nervo ciático do rato pre v i amente seccionado no lado direito com a utilização de sutura (grupo A), adesivo de fibrina (grupo B) ou uma combinação das duas técnicas (grupo C). Não houve diferença entre os grupos na avaliação do potencial de ação do nervo. Quando consideradas a latência e a velocidade de condução mensurados na re o p eração e a razão entre a velocidade de condução medida na reoperação e o mesmo parâmetro antes da secção do nervo, durante a mensuração do potencial de ação motor, os animais do grupo B apre s e n t a r a m melhores resultados em relação aos do grupo A (p<0,05). Os animais do grupo C apresentaram melhores resultados em comparação com os do grupo A quando considerada a razão entre a velocidade de condução medida 24 semanas do re p a ro e antes da secção do nervo durante a avaliação do potencial de ação m o t o r. Conclui-se que os animais em que o re p a ro dos nervos foi realizado com o adesivo de fibrina apresentaram melhores resultados em comparação com a sutura quando considerados os parâmetros obtidos na mensuração do potencial de ação motor. PALAVRAS-CHAVE: adesivo de fibrina, regeneração nervosa, sutura, nervo ciático do rato.

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“…Some experimental studies [25][26][27] showed that the result of fibrin glue repair was comparable to that of standard microsurgical repair. The gluing technique can avoid the drawbacks associated with microsurgical techniques.…”

Section: Discussionmentioning

confidence: 85%

Reconstruction of rat peripheral nerve gap without sutures using freeze-dried alginate gel

Suzuki

Tanihara

et al. 2000

J. Biomed. Mater. Res.

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Many materials have been used for artificial tubular prostheses to assist peripheral nerve gap reconstruction. However, the clinical use of these devices has been restricted because a microsurgical procedure requires specialized techniques and expensive equipment, such as operating microscope systems. Therefore the authors developed a new gluing method, without sutures, that uses freeze-dried alginate gel. A 7-mm gap in the sciatic nerve of rats was bridged with freeze-dried alginate gel. Regeneration was evaluated by electrophysiologic testing and histologic study. Eighteen weeks after surgery, functional reinnervation of motor and sensory nerves had occurred, as demonstrated by recovery of compound muscle action potentials (CMAP), compound nerve action potentials (CNAP), and somatosensory-evoked potentials (SEP). Histologically, many regenerated nerve fasciculi, including myelinated and unmyelinated fibers, were observed and the implanted alginate gel had disappeared. In conclusion, a gluing technique using alginate gel is a potential alternative to the conventional nerve autograft technique. Advantages include simple application and rapid repair. Freeze-dried alginate gel is a promising material for artificial nerve guides for peripheral nerves and also could be used for repair of disrupted pathways in central nervous tissue that is amorphous and cannot be sutured.

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A New Fibrin Seal in Primary Repair of Peripheral Nerves

Cited by 28 publications

References 11 publications

Platelet-Rich Plasma Promotes Axon Regeneration, Wound Healing, and Pain Reduction: Fact or Fiction

Platelet-Rich Plasma Promotes Axon Regeneration, Wound Healing, and Pain Reduction: Fact or Fiction

Electrophysiologic assessment of regeneration in rat sciatic nerve repair using suture, fibrin glue or a combination of both techniques

Reconstruction of rat peripheral nerve gap without sutures using freeze-dried alginate gel

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