Problems of fibrin adhesion of the nerves

Although the fibrin adhesion enjoys increasing success in many areas of surgery, it has not, however, become fully established in nerve anastomosis. It was in this area particularly that significant advantages were expected. As the fibrin clot dissolved prematurely, however, and dehiscences ensued, antifibrinolytic substances had to be added to the adhesive. Fibroses occurred frequently as a result, which to date encumber nerve adhesive. We examined various factors of the adhesive system for their fibrosis-inducing effect. We were able to establish that no additional fibrosis-promoting effect emanated from aprotinin and the fibrin clot as a supply barrier, whereas thrombin, Factor XIII and fibronectin possess a fibrosis-promoting effect.