Preliminary investigation of a polyethylene glycol hydrogel “nerve glue”

Abstract

BackgroundPolyethylene glycol (PEG) hydrogel is a biocompatible semi-adherent gel like substance that can potentially augment nerve repair much like a fibrin sealant. Potential advantages of this substance include fast preparation and set up time, as well as adhesion inhibiting properties. The purpose of this study was to perform an initial evaluation of PEG hydrogel in this application.MethodsThe sciatic nerves of 29 rats were transected and repaired using two 10-0 nylon sutures and either PEG hydrogel or fibrin glue. After 10 weeks, contraction forces of the reinnervated muscles were evaluated and histological assessment of scar tissue performed.ResultsMuscle strength testing revealed the average ratio of experimental to control sides for the fibrin glue group was 0.75 and for the PEG hydrogel group was 0.72 (no significant difference). Longitudinal sections through the nerve repair site showed no significant difference in nerve diameter but did demonstrate a significant reduction in scar thickness in the PEG hydrogel group (p < 0.01).ConclusionThough further study is necessary to fully evaluate, PEG hydrogel results in less scar tissue formation and equivalent muscle recovery as fibrin sealant when applied as a nerve glue in a rodent sciatic nerve repair model.

Advancing the technology for head transplants: From immunology to peripheral nerve fusion

“…Additional stability came from adding a drop of fibrin glue (PEG works equally well). [9] In sum, his idea was thus to minimize the secondary damage that accompanies peripheral nerve transection: chlorpromazine would thwart the deleterious effects of calcium influx into the axonal compartment and PVA would stall stump swelling due to water influx. This would be especially vital in the case of the distal stump that would undergo fragmentation and degeneration.…”

Evaluation of complication rates of pediatric spinal procedures in which a polyethylene glycol sealant was used

“…Polyethylene glycol sealant is highly adherent to tissues and has been used to join nerves together. 6 Following its efficacious period of augmenting sutures and forming a tighter seal around tears, PEG sealant is eventually broken down by water molecules 4-8 weeks later and is absorbed by the body.…”

Polyethylene Glycol: The Future of Posttraumatic Nerve Repair? Systemic Review

“…Bittner et al speculated that the unusual PEG fusion protocol used by Brown et al might not be optimal, and the lack of results of PEG fusion could be due to the use of incorrect solutions [61]. Issacs et al also did not observe enhanced nerve regeneration (measured by muscle contraction force and nerve diameter assessment) [48]. It should be noted, however, that their study was designed mainly to evaluate whether PEG application reduced scar formation compared to fibrin glue (and indeed it proved PEG’s superiority in reducing a scar’s thickness).…”

“…The volume of solution needed to cover the whole treated nerve varies each time. An isolated PEG application, independent of the protocol, does not result in better PNI recovery [48]. Apart from the direct use of a PEG solution on the nerve coaptation site, PEG is also used in bridging nerve gaps, as a conduit material (solid PEG), or as a conduit filling (PEG solution) [49,50].…”