Fibrin glue matches suture repair for peripheral nerve repair

Fibrin glue achieves comparable nerve regeneration outcomes as suture repair, reports a new meta-analysis.

“Combining fibrin glue with one or two positional sutures allows for a precise realignment of the nerve fibres and seems to provide sufficient strength to prevent dehiscence,” the researchers said.

A systematic search of online databases Google Scholar, Medline, Embase, Web of Science, and Cochrane yielded four human studies, two cadaveric studies, and 37 animal studies eligible for inclusion. All studies looked at least one of the following: functional, electrophysiology, histopathology, biomechanical, and operation outcomes of peripheral nerve repair using fibrin glue.

Twenty-one animal studies examined functional outcomes of nerve repair, including functional index, muscle mass, and muscle strength, all of which were reported by at least three studies. Fibrin glue resulted in no significant difference vs suture repair for functional index (standardized mean difference [SMD], 0.33, 95 percent confidence interval [CI], –0.56 to 1.22) and muscle strength (SMD, 0.19, 95 percent CI, –0.33 to 0.71).

Notably, the combination of fibrin glue and suture yielded significantly better muscle mass outcomes than fibrin glue alone (SMD, –0.51, 95 percent CI, –0.86 to –0.17).

Electrophysiology, histology, and biomechanical outcomes were comparable between fibrin glue and suture repairs.

Further focusing on human studies showed that both suture repair and fibrin glue groups achieved comparable levels of motor and sensory function at the final follow-up. Grip strength, hand outcome scores, electrophysiology findings, and postoperative complications were all also comparable between groups.