Journal
JOURNAL OF HAND SURGERY-AMERICAN VOLUME
Volume 33A, Issue 6, Pages 893-899Publisher
W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1016/j.jhsa.2008.02.009
Keywords
biomechanical testing; fibrin glue; nerve repair; noncontact strain analysis; suture repair
Categories
Ask authors/readers for more resources
Purpose To compare a variety of potentially useful artificial and biological sealants applied to sutured nerve repairs to decrease gapping at the repaired site. Methods Fifty-seven fresh-frozen cadaveric nerve specimens were transected and repaired with two 8-0 nylon epineural sutures placed 180 degrees apart. The specimens were divided into 5 groups. Four groups received augmentation of the repair with application of either autologous fibrin glue, Tisseel fibrin glue, Evicel fibrin glue, or DuraSeal polyethylene glycol-based hydrogel sealant, and the fifth group had no glue. Each nerve construct was mounted in a servohydraulic materials testing machine and stretched at a constant 5 mm/min displacement rate until failure. A noncontact video analysis permitted normalization of stretch within the repair region. Statistical analysis was performed via analysis of variance followed by Tukey-Kramer post hoc pairwise comparison when indicated. Results Resistance to gapping as measured through normalized stiffness (N/mm/mm) was greater for the Tisseel group, Evicel group, and DuraSeal group versus the no-glue group only. The stiffness of the autologous group approached significance versus the no-glue group. There were no significant differences in stiffness between any of the nerve glue groups. There was no statistical difference for the peak load at failure between any of the groups. Conclusions Avoidance of gapping at the nerve repair site is crucial in achieving successful nerve regeneration. Commercially available tissue sealants (Tisseel, Evicel, and DuraSeal), when used to augment 2-suture nerve repairs, as in our protocol, help prevent this initial gapping. None of the tissue sealants tested, however, increased the ultimate load to complete failure of the repair.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available