Inalöz S S, Ak H E, Vayla V, Akin M, Aslan A, Sari I, Celik Y, Ozkan U
Department of Histology and Embryology, Dicle University Medical Faculty, Diyarbakir, Turkey.
Neurosurg Rev. 1997;20(4):250-8. doi: 10.1007/BF01105896.
The purpose of this study was to investigate and to compare the effects of microsuturing to that of tissue adhesives (Tisseel) on the healing of anastomosing peripheral nerve incisions. Forty-five Wistar-Albino rats were placed in special cages and separated into three groups (n = 15). In the control group, biliteral sciatic nerves were explored but no incision was made. In the first experimental group, bilateral sciatic nerves were incised and end-to-end anastomosing was performed by microsuturing the epineurium. In the second experimental group, tissue adhesive (Tisseel) was used alone in anastomosing the sciatic nerve cuts. Assessments of the healing processes were demonstrated by 1.electromyography (EMG), 2. measuring the electrical responses of the anastomosed nerves after electrical stimuli, 3. histopathological examination. Statistical analysis of the EMG findings showed that the Tisseel group was the closest in the healing process to the control group. After applying electrical stimuli to the dissected nerves, the resistance value of the Tisseel group was nearest to those of the control group. The histopathological examinations showed highly degenerative nerve bundles and prominent foreign body granuloma at the anastomosed sites of the microsutured group. The granulomatous inflammation was observed to be much less in the Tisseel group. We conclude that the healing effect of Tisseel was found to be superior to that of microsuturing as demonstrated by the findings of EMG, electrical responses of the anastomosed nerves, and histopathological examination.
本研究的目的是调查并比较显微缝合与组织粘合剂(Tisseel)对周围神经吻合切口愈合的影响。将45只Wistar白化大鼠置于特殊笼中,分为三组(n = 15)。对照组中,双侧坐骨神经被探查但未做切口。在第一实验组中,双侧坐骨神经被切开,通过显微缝合神经外膜进行端端吻合。在第二实验组中,单独使用组织粘合剂(Tisseel)进行坐骨神经切口吻合。通过以下方式对愈合过程进行评估:1. 肌电图(EMG);2. 测量电刺激后吻合神经的电反应;3. 组织病理学检查。对EMG结果的统计分析表明,Tisseel组在愈合过程中最接近对照组。对解剖后的神经施加电刺激后,Tisseel组的电阻值最接近对照组。组织病理学检查显示,显微缝合组吻合部位的神经束高度退化,有明显的异物肉芽肿。在Tisseel组中观察到的肉芽肿性炎症要少得多。我们得出结论,根据EMG结果、吻合神经的电反应和组织病理学检查结果,发现Tisseel的愈合效果优于显微缝合。