# A Sutureless Approach to Nerve Repair: Results From a Clinical Study in Digital Nerves

## TL;DR

A new sutureless method using a bioresorbable polymer successfully repaired digital nerves in 12 patients, showing safety and effectiveness over 12 months.

## Contribution

The study introduces a sutureless nerve repair technique using a PGSA polymer device, validated in a clinical trial.

## Key findings

- All patients achieved excellent or good sensory recovery at 12 months.
- No device-related complications or pain were reported after 12 months.
- Patients returned to work within a median of 41.5 days.

## Abstract

Traditional microsurgical suture neurorrhaphy presents challenges such as fascicular trauma, scar formation, and variability in repair quality. This clinical study evaluates the safety and efficacy of a bioresorbable poly(glycerol sebacate) acrylate (PGSA) polymer-assisted device in digital nerve repair without sutures.

A single-arm clinical trial enrolled 12 patients with digital nerve injuries at two centers. The repair involved securing severed nerve ends within a 3-dimensional printed PGSA coaptation chamber using a light-activated PGSA polymer. Patients were prospectively followed for 12 months with assessments including pain (visual analog scale pain score), sensory recovery (Semmes-Weinstein Monofilament and two-point discrimination), patient-reported outcomes (Impact of Hand Nerve Disorders Questionnaire v2.0), and high-resolution ultrasound imaging.

At 12 months, 10 patients who completed the study had a Semmes-Weinstein Monofilament score of 0.4 (“diminished light touch”) or better, with 100% achieving “Good” (S3+) or “Excellent” (S4) two-point discrimination scores. No patient reported pain at 12 months, and no device-related complications were recorded. Ultrasound confirmed intact repairs with no neuroma formation. All patients returned to work at a median time of 41.5 days.

Results from this study support the concept of sutureless repair of severed digital nerves using the PGSA polymer-assisted coaptation device by demonstrating that the PGSA polymer-assisted coaptation is safe, effective, and may be considered as an option for nerve approximation.

These findings support the potential for broader clinical applications of polymer-assisted sutureless nerve repair.