Autologous fibrin tissue adhesive for peripheral nerve anastomosis

The sciatic nerve in rabbits was exposed, transected, and repaired using either of two methods. The experimental group had an autologous fibrin-based adhesive repair. The control group had conventional perineural suturing. The autologous tissue glue is similar in composition, handling, and performance to the commercially available European product Tisseel. It can be prepared quickly without sophisticated equipment or expense. Autologous glue obviates the risk of transmissible disease that has precluded approval of the commercial product for use in the United States. The glued anastomosis can be performed with accurate apposition and minimal trauma to the nerve. By making a fibrin cocoon, the anastomosis can be insulated. This provides some of the benefits of sheathed anastomosis while minimizing foreign body reaction. Functional evaluation and histologic results comparing the amount of anastomotic fibrosis, axonal regeneration, and alignment of fascicles showed glue to be as good as, if not superior to, conventional suture technique.