Use of fibrin glue in the repair of brachial plexus and peripheral nerve injuries

Abstract

Background

Brachial plexus and other peripheral nerve injuries present with considerable functional impairment. Surgical outcomes following repair of such injuries are generally considered to be poor. Traditionally nerve repairs are performed with synthetic micro sutures under high power magnification. This not only takes considerable operating time, but also may induce local inflammatory response and fibrosis, which hampers the distal migration of axonal sprouts. An alternative technique for nerve repair is the use of fibrin glue.

Methods

Commercially available fibrin glue has been used in the repair of brachial plexus and peripheral nerve injuries. This technique has been evaluated for the ease of performance, time spent in nerve fixation, strength at coaptation sites and ultimate functional recovery.

Results

Coaptation of nerves with fibrin glue is a relatively simple technique performed under loupe magnification without the need of an operating microscope. The strength at coaptation site is good enough to hold the nerve ends together. No untoward effects directly related to the use of fibrin glue are observed in the operated patients. The most important aspect in using fibrin glue is a reduction in operating time by almost 30%, when compared with conventional suturing techniques using synthetic micro sutures. Functional results are comparable to those usually obtained with sutures.

Conclusion

Use of fibrin glue is an alternative and effective technique in the repair of brachial plexus and peripheral nerve injuries. This technique of nerve coaptation considerably reduces the operating time which is an important factor in the management of nerve injuries.

Keywords

Fibrin glue - Micro suture - Brachial plexus - Peripheral nerve repair

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