Use of Erythropoietin and Fibrin Glue Mixture for Peripheral Nerve Repair

Abstract

Background: Erythropoietin has neuroregenerative effects. Fibrin glue may be used for nerve repair and controlled release of substances. In this study, the authors investigated the effects of erythropoietin-containing fibrin glue on nerve repair, based on the hypothesis that erythropoietin-containing fibrin glue would positively affect nerve regeneration. Methods: Thirty-six Long-Evans rats were used. The animals were divided into six groups. Their left sciatic nerves were isolated, transected, and repaired with saline-containing fibrin glue in group 1, with erythropoietin-containing fibrin glue in group 2, with saline-containing fibrin glue and two sutures in group 3, with erythropoietin-containing fibrin glue and two sutures in group 4, with two sutures in group 5, and with four sutures in group 6. Sciatic Functional Index calculation, pin-prick test, and toe-spread test were performed on days 21, 42, and 63. All animals were killed on day 63. The nerve sections were analyzed histologically. Results: The Sciatic Functional Index, pin-prick test, and toe-spread test results were the best in group 4 and the worst in group 5. Group 4 showed superior Schwann cell proliferation (p < 0.05). Groups with epineural suture use (groups 3, 4, 5, and 6) had higher endoneurial collagen synthesis scores than the groups without suture use (groups 1 and 2) (p < 0.05). The myelin protein zero immunostaining results were significantly higher in the erythropoietintreated groups (groups 2 and 4) (p < 0.05). Conclusion:The combined use of erythropoietin-containing fibrin glue and two epineural sutures (group 4) showed a statistically significant improvement in many parameters. (Plast. Reconstr. Surg. 149: 395, 2022.) Clinical Relevance Statement: Fibrin glue is already used in nerve repair. Adding erythropoietin to fibrin glue could be a safe and easy option to improve nerve regeneration.

Nerve Regeneration after a Nerve Graft in a Rat Model: The Effectiveness of Fibrin Glue

“…Despite Tisseel ® being introduced more than four decades ago, there is still limited literature on its application and effectiveness in repairing peripheral nerves, with most studies focusing on its efficacy in rat models [9,10,12,21,[29][30][31][32][33][34][35][36][37][38][39][40]. This could be attributed to two main factors.…”

“…However, most of the assessed studies were carried out on animal models, with the use of different types of glue and different types of evaluated parameters [9,10,12,21,[29][30][31][32][33][34][35][36][37][38][39][40].…”

Adipose stem cells in tissue regeneration and repair: From bench to bedside

“…Scaffold materials commonly used in the repair of peripheral nerve injury include artificial nerve conduits such as acellular allogeneic nerve grafts (ANAs), polycaprolactone (PCL) conduits, fibrin conduits, etc [ [122] , [123] , [124] ]. ANAs is a cell-free scaffold material that minimizes antigenicity [ 125 ].…”