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 language | English |
|---|---|
| Pages (from-to) | 1018-1033 |
| Number of pages | 16 |
| Journal | Journal of Plastic, Reconstructive and Aesthetic Surgery |
| Volume | 75 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 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