Structural and functional regeneration in hairy and glabrous skin after fibrin sealing of transected peripheral nerves in the rat

Abstract

Fibrin sealing of nerves has become a commonly used technique in the treatment of brachial plexus injuries as it is quicker than microsuture, but the tensile strength of the fibrin has been in question. A new fibrin (Tisseel-DUO®, Immuno; Austria) is now available which we have previously studied and with which we had no anastomotic failures. This study is a continuation of our previous work and the aim was to evaluate further the histological and functional outcome after repair with this new product. The sciatic nerves in 15 rats were divided and rejoined with fibrin. The animals were allowed to survive for 3 months and their movement was unrestricted from immediately after the operation. The numbers of myelinated and unmyelinated axons were evaluated after regeneration at × 5000 and × 14 000 respectively. Regenerated function of polymodal nociceptors and low threshold mechano-receptors were evaluated in hairy and glabrous skin. Results from normal rats (n = 15) and rats that had undergone neurotomy and microsuture (n = 15) were used for comparison. After regeneration, counts of myelinated and unmyelinated axons in branches to hairy and glabrous skin differed significantly (P ≤ 0.05) when fibrin was used compared with microsuture, but this difference was not reflected in the functional regeneration. We conclude that this product may be a time saving alternative to microsuture of peripheral nerves in patients.