Sense and Sensibility: Nerve Tape-A More Efficient Alternative for Nerve Repair in Breast Reconstruction?

Background: Current methods of nerve coaptation, ranging from epineural microsuture to fibrin glue, are either technically challenging or inadequate in providing robust repair. Nerve Tape, a novel sutureless nerve coaptation device, addresses these shortcomings by enabling rapid application while still preserving high-quality nerve repair. The purpose of this study was to compare the speed and quality of nerve repair between Nerve Tape and the traditional microsuture in patients who undergo cancer-related and gender-affirming mastectomies with chest/breast reinnervation. Methods: Fourteen surgeon participants performed direct coaptations between the lateral cutaneous branches of intercostal nerves and either medial intercostal nerve branch autograft or allograft. Neurorrhaphy was randomized and performed with microsuture on 1 breast/chest and Nerve Tape on the contralateral breast/chest. Repair time and repair quality, graded with a standardized neurorrhaphy grading scale, were compared between the 2 repair methods. Results: The mean repair time using Nerve Tape and microsuture was 1.79 and 5.20 minutes, respectively. Nerve Tape repair required less than half the time of microsuture repair for trainees of all postgraduate year levels. The repair quality was excellent or good in 92% of Nerve Tape coaptations and 69% of microsuture repairs. Conclusions: Nerve Tape enables faster repair times and higher rates of clinically acceptable nerve coaptation, regardless of the surgeon's level of experience. This sutureless technology proves to be a potentially promising alternative to traditional microsurgical suture repair, though more studies are needed to establish a correlation with clinical outcomes.