Narakas A
Medical School, University of Lausanne, Switzerland.
Orthop Clin North Am. 1988 Jan;19(1):187-99.
Gluing of nerves with histocompatible and resorbable materials offers a distinct advantage on suturing alone because results in clinical surgery are similar and often better. This method, when applied properly, allows a considerable gain of operative time, which we estimate to be 3-fold (ie, instead of taking 1 hour for grafting one nerve trunk, it takes 20 minutes). It does not represent a breakthrough in peripheral nerve surgery because it does not guarantee that each nerve fiber will be aligned with its own stump. Gross evaluation shows that the percentage of good results is increased by approximately 15 per cent. It must be stressed, however, that a portion of this improvement, difficult to evaluate, may be caused not by the method but by the experience we have gained over the years practicing nerve repair. The commercial fibrin glue is not yet released in the United States by the Food and Drug Administration; however, it seems, at the time of this writing, that this will be done by the first months of 1988.
使用组织相容性和可吸收材料粘合神经比单纯缝合具有明显优势,因为临床手术结果相似且往往更好。这种方法如果应用得当,可显著节省手术时间,我们估计能节省三倍时间(即,移植一根神经干原本需要1小时,现在只需20分钟)。它并非外周神经手术的突破,因为它不能保证每根神经纤维都能与自身残端对齐。总体评估显示,良好结果的百分比大约提高了15%。然而,必须强调的是,这种难以评估的改善部分可能并非由该方法所致,而是源于我们多年来进行神经修复积累的经验。商业用纤维蛋白胶尚未获得美国食品药品监督管理局的批准;不过,在撰写本文时,似乎将于1988年的头几个月获批。