Heterologous fibrin sealant potentiates axonal regeneration after peripheral nerve injury with reduction in the number of suture points

Author(s)

Silveira Leite, Ana Paula ^{[1, 2]} ; Pinto, Carina Guidi ^{[1, 2]} ; Tiburcio, Felipe Cantore ^[2] ; Sartori, Arthur Alves ^[2] ; Rodrigues, Antonio de Castro ^[3] ; Barraviera, Benedito ^[4] ; Ferreira Junior, Rui Seabra ^[4] ; Filadelpho, Andre Luis ^[2] ; Michelin Matheus, Selma Maria ^[2]

Affiliation

^[1] Sao Paulo State Univ Unesp, Univ Estadual Paulista Julio de Mesquita Filho, Botucatu Med Sch, Grad Program Gen Bases Surg, Inst Biosci, Dept Anat, Travessa Rua Prof Dr Gilberti Moreno Sao Paulo, BR-18618689 Botucatu, SP - Brazil

^[2] Sao Paulo State Univ Unesp, Inst Biosci, Univ Estadual Paulista Julio de Mesquita Filho, Dept Anat, Travessa Rua Prof Dr Gilberti Moreno Sao Paulo, BR-18618689 Botucatu, SP - Brazil

^[3] Unifai Ctr Univ Adamantina, Adamantina, SP - Brazil

^[4] UNESP, Ctr Study Venoms & Venomous Anim, Botucatu, SP - Brazil

• Document type: Journal article
• Source: INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED; v. 50, n. 4, p. 834-847, APR 2019.
• Web of Science Citations: 1

Abstract

The use of suture associated with heterologous fibrin sealant has been highlighted for reconstruction after peripheral nerve injury, having the advantage of being safe for clinical use. In this study we compared the use of this sealant associated with reduced number of stitches with conventional suture after ischiatic nerve injury. 36 Wistar rats were divided into 4 groups: Control (C), Denervated (D), ischiatic nerve neurotmesis (6 mm gap); Suture (S), epineural anastomosis after 7 days from neurotmesis, Suture + Fibrin Sealant (SFS), anastomosis with only one suture point associated with Fibrin Sealant. Catwalk, electromyography, ischiatic and tibial nerve, soleus muscle morphological and morphometric analyses were performed. The amplitude and latency values of the Suture and Suture + Fibrin Sealant groups were similar and indicative of nerve regeneration. The ischiatic nerve morphometric analysis in the Suture + Fibrin Sealant showed superior values related to axons and nerve fibers area and diameter when compared to Suture group. In the Suture and Suture + Fibrin Sealant groups, there was an increase in muscle weight and in fast fibers frequency, it was a decrease in the percentage of collagen compared to group Denervated and in the neuromuscular junctions, the synaptic boutons were reestablished. The results suggest a protective effect at the lesion site caused by the fibrin sealant use. The stitches reduction minimizes the trauma caused by the needle and it accelerates the surgical practice. So the heterologous fibrin sealant use in nerve reconstruction should be considered. (C) 2019 Elsevier Ltd. All rights reserved. (AU)

• FAPESP's process: 17/06472-2 - Analyses of the neuromuscular junctions and associated proteins with focus on morphofunctional recovery: a comparative use of fibrin sealant and suture.
• Grantee: Selma Maria Michelin Matheus
• Support Opportunities: Regular Research Grants