Neurosurgical Review

, Volume 37, Issue 4, pp 585–595 | Cite as

Nerve repair: toward a sutureless approach

  • Matthew J. Barton
  • John W. Morley
  • Marcus A. Stoodley
  • Antonio. Lauto
  • David A. Mahns
Review

Abstract

Peripheral nerve repair for complete section injuries employ reconstructive techniques that invariably require sutures in their application. Sutures are unable to seal the nerve, thus incapable of preventing leakage of important intraneural fluids from the regenerating nerve. Furthermore, sutures are technically demanding to apply for direct repairs and often induce detrimental scarring that impedes healing and functional recovery. To overcome these limitations, biocompatible and biodegradable glues have been used to seal and repair peripheral nerves. Although creating a sufficient seal, they can lack flexibility and present infection risks or cytotoxicity. Other adhesive biomaterials have recently emerged into practice that are usually based on proteins such as albumin and collagen or polysaccharides like chitosan. These adhesives form their union to nerve tissue by either photothermal (tissue welding) or photochemical (tissue bonding) activation with laser light. These biomaterial adhesives offer significant advantages over sutures, such as their capacity to unite and seal the epineurium, ease of application, reduced invasiveness and add the potential for drug delivery in situ to facilitate regeneration. This paper reviews a number of different peripheral nerve repair (or reconstructive) techniques currently used clinically and in experimental procedures for nerve injuries with or without tissue deficit.

Keywords

Photochemical tissue bonding Peripheral nerve repair Nerve conduits Biomaterials Lasers Sutures 

Notes

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Matthew J. Barton
    • 1
  • John W. Morley
    • 2
    • 3
  • Marcus A. Stoodley
    • 4
  • Antonio. Lauto
    • 2
    • 3
  • David A. Mahns
    • 2
    • 3
  1. 1.Griffith Health InstituteGriffith UniversityQueenslandAustralia
  2. 2.School of MedicineUniversity of Western SydneyPenrithAustralia
  3. 3.The Bioelectronics and Neuroscience (BENS) Research Group, The MARCS InstituteUniversity of Western SydneyPenrithAustralia
  4. 4.The Australian School of Advanced MedicineMacquarie UniversitySydneyAustralia

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