[The effect of fibrin gluing and its important components on fibrosis of nerve anastomoses]

Abstract

The fibrinous adhesion, although generally adopted and more and more successfully applied in many sectors of surgery, is not yet fully established in the anastomosis of separated nerves. Initially, the adhesion was expected to offer some essential advantages in this domain, especially in the prevention of suture granulomas. However, the blood clots dissolved too early, and this resulted in the formation of dehiscences. So antifibrinolytic substances had to be added to the adhesive, and this led to a frequent appearance of fibroses. The adhesion of nerves is still hampered by this fact. Now we have examined the fibrosis-inducing effect of different factors of the adhesive system. We found that aprotinin and the fibrin clot as an obstacle to supply had no additional fibrotic effect, whereas thrombin, factor XIII and fibronectin promoted the formation of fibroses.