Results of Nerve Grafts with Tissucol (Tisseel) Anastomosis

  • D. V. Egloff
  • A. Narakas
  • C. Bonnard
Conference paper

Abstract

Between 1980 and 1982, 56 peripheral nerve repairs were made with Tissucol. For technical reasons combined anastomoses were chosen in brachial plexus repairs (23 cases) and main nerve trunk repairs (17 cases), Tissucol alone being used in most other cases (8 free flaps, 8 digital nerves). A preliminary report was published in 1983. The results compared well with the so-called classical repair methods using stitches. The same cases were reviewed for long-term follow-up, which confirmed the conclusions of the preliminary report:
  1. 1.

    The glue applied as a kind of sleeve around the neurosynthesis site creates a regeneration chamber protecting the nerve stumps against invading neighboring tissues and restricts axon sprout escape

     
  2. 2.

    There is no impairment of axonal growth through the single (mainly free toe transfers) and the proximal anastomoses

     
  3. 3.

    There is an impairment of axonal growth through the distal anastomosis proportional to the length of the graft

     
  4. 4.

    The main advantage is the gain in operative time

     
  5. 5.

    It is necessary to use slightly longer grafts than with classical methods, to avoid any tension which would be deleterious

     
  6. 6.

    The other advantages are: hemostasis, stabilization and solidarization of small grafts allowing sharp division, atraumatic direct muscle neurotization

     
Since 1983 a slight change has been introduced to the technique: using a few stitches, in most cases, before Tissucol is applied so as to maintain orientation and coaptation during the glueing process and the first postoperative hours.

Key words

Fibrin Tissucol Nerve Graft microsurgery 

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Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • D. V. Egloff
  • A. Narakas
  • C. Bonnard

There are no affiliations available

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