The neurosurgical comparison of microsuturing with the tissue adhesives

The purpose of this study was to investigate and to compare the healing effects of microsuturing to that of tissue adhesives (Tiseef®) in anastomosing peripheral nerve incisions. Assessments of the healing processes were demonstrated by using 1) electromyography (EMG), 2) measuring the electrical responses of the anastomosed nerves after electrical stimuli, 3) histopathologically. In the control group of rats, bilateral 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 (Tiseef®) was used in anastomosing the sciatic nerve cuts. After one month, EMG assessments were performed in all rats. After EMG measurements, bilateral sciatic nerves were explored at the site of anastomoses and 2 cm lengths were biopsied at both sites. Immediately after, the electrical responses of the dissected nerves were measured. Finally, histopathological assessment were performed using a light microscope. According to the EMG findings, statistical analysis showed that the Tiseel group was the closest in the healing process to the control group. After applying the electrical stimuli to the dissected nerves, the nearest resistance value to the control group was found to be in the Tiseel group. The histopathological examinations showed higly degenerative nerve bundles and prominent foreign body granuloma at the anastomosed sites of the microsutured group. The granulomatous inflammation was much less observed in the Tiseel group. The healing effect of Tiseel was found to be superior to that of microsuturing as demonstrat­ ed by the findings of EMG, electrical responses of the anastomosed nerves and histopathological examination. [Turk J Med Res 1996; 14(2):42-47]