A systematic review and meta-analysis on the use of fibrin glue in peripheral nerve repair: Can we just glue it?

J. E. Koopman*, L. S. Duraku, T. de Jong, R. B. M. de Vries, J. Michiel Zuidam, C. A. Hundepool

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Scopus)
22 Downloads (Pure)

Abstract

Background: Within the field of peripheral nerve surgery, the use of fibrin glue as an alternative to conventional microsurgical suture repair is becoming increasingly popular. Advantages of fibrin glue for nerve reconstruction include technical ease of use, less tissue manipulation, and shorter operation times. Although fibrin glue seems a promising alternative to conventional microsurgical repair, further insight into the outcomes of nerve recovery is essential. Objective: To summarize the current literature on the use of fibrin glue for peripheral nerve repair and compare these results with outcomes following conventional suture repair. Methods: A systematic search in Embase, MEDLINE, Web of Science, Cochrane, and Google Scholar databases was performed. The search included animal, cadaveric, and human studies assessing outcomes following peripheral nerve repair using fibrin glue. Data on outcomes were subdivided into functional outcomes, electrophysiology, histopathology, biomechanical outcomes, and operation times. We calculated standardized mean differences and combined these in a random effects model to estimate the overall effect. Results: From a total of 2057 references, 37 animal, two cadaveric, and four human studies were included. Fibrin glue repairs resulted in similar functional and electrophysiology outcomes and shorter operation times than suture repairs. However, fibrin glue alone resulted in lower strength and more dehiscence. No dehiscence was reported when fibrin glue was combined with one or two sutures. Yet, we also found that methodological details were poorly reported in animal studies, resulting in an unclear risk of bias. This should be taken into consideration when interpreting the results. Conclusion: The results indicate that nerve regeneration may be similar in fibrin glue repairs and suture repairs. Combining fibrin glue with one or two positional sutures allows for a precise realignment of the nerve fibers and seems to provide sufficient strength to prevent dehiscence.

Original languageEnglish
Pages (from-to)1018-1033
Number of pages16
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Volume75
Issue number3
DOIs
Publication statusPublished - Mar 2022

Bibliographical note

Funding Information:
The authors would like to thank Wichor Bramer, biomedical information specialist at the Erasmus MC University Medical Center, for assisting with the systematic search strategy and syntax. This work was funded by ZonMw (Project Number: 114024161) in the program ‘Meer Kennis met Minder Dieren’ (MKMD). ZonMW had no role in the study design and collection, data analysis, interpretation of data, or writing the manuscript. Not required.

Funding Information:
This work was funded by ZonMw (Project Number: 114024161) in the program ‘Meer Kennis met Minder Dieren’ (MKMD). ZonMW had no role in the study design and collection, data analysis, interpretation of data, or writing the manuscript.

Publisher Copyright:
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons

Fingerprint

Dive into the research topics of 'A systematic review and meta-analysis on the use of fibrin glue in peripheral nerve repair: Can we just glue it?'. Together they form a unique fingerprint.

Cite this