[Choice of thrombin concentration of common fibrin glue systems for nerve anastomosis]

Although fibrin glue has been used in several areas of surgery with increasing success, it has not become fully established in nerve coaptation. Initially, significant advantages were expected, however, as the fibrin clot dissolved prematurely, gapping occurred and antifibrinolytic substances had to be added to the glue. Following this procedure, fibrosis occurred frequently. This remains a problem. Therefore, the dosage dependent fibrosis-inducing effect of thrombin was investigated in an animal experimental study. Thrombin demonstrates a fibrosis-promoting effect and we therefore recommend 1-1.5 NIH thrombin/ml glue, as lower concentrations increase the clotting time.