A New Fibrin Seal: Functional Evaluation of Sensory Regeneration Following Primary Repair of Peripheral Nerves

A new fibrin seal has recently been evaluated in terms of axonal regeneration; however morphological examination of the fibre composition of regenerated nerves may not necessarily provide functionally relevant information. This study therefore aims to evaluate the functional regenerated sensation, following peripheral nerve transection treated with fibrin seal (Tisseel-Duo, Immuno; Austria). The sural nerve-innervated skin of the rat hindfoot served as the target organ. Previously published results from animals following transection and suture served as controls. Ten 3-month-old female Sprague-Dawley rats were used. The sciatic nerve was divided and rejoined with fibrin seal. The rats were allowed unrestricted movement directly after surgery and allowed to survive for 3 months. Our observations show that the functional results of regenerated polymodal nociceptors and low-threshold mecanoreceptors show no statistical difference when compared with microsuture. This strengthens the early positive morphological impression of this new product. Further prospective studies in man are anticipated.

A New Fibrin Seal in Primary Repair of Peripheral Nerves

Fibrin sealing, with or without sutures, has become a commonly used technique in human nerve grafting with clinically good results, but is seldom used in primary repair of peripheral nerves. A prospective study was designed to evaluate the incidence of dehiscence in the traditional (Tisseel Kit) and a new “ready-to-use” fibrin seal preparation (Tisseel Duo), and the outcome following fibrin sealing was compared with microsurgical repair of peripheral nerves in rats. No dehiscence was seen in the Tisseel Duo group compared with 20% in the Tisseel Kit group. The electron micrographic evaluation following regeneration showed no significant difference from the microsuture group. Tisseel Duo should therefore be used instead of the traditional fibrin seal preparation when no sutures are used, and may prove to be an alternative to microsuture of peripheral nerves.