Advances in Clinical and Experimental Medicine
2015, vol. 24, nr 1, January-February, p. 23–29
Publication type: original article
The Effect of Hemostatic Agents and Tissue Adhesive on Injured Peripheral Nerve Healing in Rats – Part I. Electrophysiological Study
1 Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ondokuz Mayıs University, Samsun, Turkey
2 Department of Physiology, Faculty of Medicine, Ondokuz Mayıs University, Samsun, Turkey
Background. In the practice of maxillofacial surgery, bleeding and nerve injury have common problems. In the control of bleeding, hemostatic agents and tissue adhesives have been frequently used. The effect of these hemostatic agents and tissue adhesives on the injured neural tissues has not been known.
Objectives. In this study, we aimed to investigate the effects of hemostatic agents and tissue adhesive on injured nerve tissues.
Material and Methods. Forty-two rats randomly divided into seven groups: Control, Oxidized Regenerated Cellulose (ORC), Gelatine Sponge (GS), Bovine Collagen (BC), Ankaferd BloodStopper (ABS), Glutaraldehyde Surgical Adhesive (BioGlue®) and N-butil-2 cyanoacrylate (Glubran®2). The left sciatic nerves were crushed and surrounded by hemostatic agents and tissue adhesives. At the end of 12 weeks, the surgical site was reopened and electrophysiological recordings were performed.
Results. In the ORC, GS, and BC groups, the compound action potential (CAP) values were lower compared to the control group (p < 0.05). Although the values of CAP in the ABS group were higher than in the control group while CAP values in the BioGlue and Glubran®2 groups were lower than the control group, there was no statistical significance between the experimental and control groups (p > 0.05). In the ORC, BC, GS, and Glubran®2 groups, the nerve conduction velocities (NCV) values were lower than in the control group (p < 0.05). In the ABS and BioGlue groups, NCV values were lower compared to the control group but no significant differences were found (p > 0.05).
Conclusion. The present study provides evidence that ABS is the most suitable hemostatic agent due to its favorable effect on the healing of injured neural tissues. BioGlue is also a suitable surgical agent with no adverse effects.
injured nerve tissues, hemostatic agents, tissue adhesives.
- Park YT, Kim SG, Moon SY: Indirect compressive injury to the inferior alveolar nerve caused by dental implant placement. J Oral Maxillofac Surg 2012, 70, 258–259.
- Meyer RA, Bagheri SC: Nerve injuries from mandibular third molar removal. Atlas Oral Maxillofac Surg Clin North Am 2011, 19, 63–78.
- Doucet JC, Morrison AD, Davis BR: Concomitant removal of mandibular third molars during sagittal split osteotomy minimizes neurosensory dysfunction. J Oral Maxillofac Surg 2012, 70, 2153–2163.
- Seddon HJ: Three types of nerve injury. Brain 1943, 66, 237–288.
- Arx TV, Jensen SS, Hänni S: Haemostatic agents used in periradicular surgery: an experimental study of their efficacy and tissue reactions. Int Endod J 2006, 39, 800–888.
- Alkan A, Inal S, Yildirim M: The effects of hemostatic agents on peripheral nerve function: an experimental study. J Oral Maxillofac Surg 2007, 65, 630–634.
- Schonauer C, Tessitore E, Barbagallo G: The use of local agents: bone wax, gelatin, collagen, oxidized cellulose. Eur Spine J 2004, 13, 89–96.
- Işler SC, Demircan S, Cakarer S: Effects of folk medicinal plant extract Ankaferd Blood Stopper on early bone healing. J Appl Oral Sci 2010, 18, 409–414.
- Haghpanah S, Vafafar A, Golzadeh MH: Use of Glubran 2 and Glubran tissue skin adhesive in patients with hereditary bleeding disorders undergoing circumcision and dental extraction. Ann Hematol 2011, 90, 463–468.
- Lemaire SA, Ochoa LN, Conklin LD: Nerve and conduction tissue injury caused by contact with BioGlue. J Surg Res 2007, 143, 286–293.
- Ozen T, Orhan K, Gorur I: Efficacy of low level laser therapy on neurosensory recovery after injury to the inferior alveolar nerve. Head&Face Med 2006, 15, 2–3.
- Tay AB, Go WS: Effect of exposed inferior alveolar neurovascular bundle during surgical removal of impacted lower third molars. J Oral Maxillofac Surg 2004, 62, 592–600.
- Hillerup S, Stoltze K: Lingual nerve injury in third molar surgery I. Observations on recovery of sensation with spontaneous healing. Int J Oral Maxillofac Surg 2007, 36, 884–889.
- Pampu A, Yildirim M, Tüzüner T: Comparison of the effects of new folkloric hemostatic agent on peripheral nerve function: an electrophysiologic study in rats. Oral Surg Oral Med Oral Pathol Oral Radiol 2012 Available at: http://www.ooooe.net/inpress. (accessed 31 May 2012)
- Loescher AR, Robinson PP: The effect of surgical medicaments on peripheral nerve function. Br J Oral Maxillofac Surg 1998, 36, 27–32.
- Fürst W, Banerjee A: Release of glutaraldehyde from an albumin-glutaraldehyde tissue adhesive causes significant in vitro and in vivo toxicity. Ann Thorac Surg 2005, 79, 1522–1529.