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Adjuvant suture repair methods have been used to improve nerve regeneration and modulate the immune response. Heterologous fibrin biopolymer (HFB), a scaffold with adhesive properties, plays a critical role in tissue repair. The aim of this study is to evaluate neuroregeneration and immune response focusing on neuromuscular recovery, using suture\u2010associated HFB for sciatic nerve repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Forty adult male Wistar rats were distributed into four groups (n\u00a0=\u00a010): C (control), only sciatic nerve location; D (denervated), neurotmesis and 6\u2010mm gap removal and fixation stumps in subcutaneous tissue; S (suture), neurotmesis followed by suture; and SB (suture\u2009+\u2009HFB), neurotmesis followed by suture and HFB. Analysis of M2 macrophages (CD206<jats:sup>+<\/jats:sup>), as well as the morphology and morphometry of nerves, soleus muscle, and neuromuscular junctions (NMJs), were performed at 7 and 30\u2009days after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The SB group had the highest M2 macrophage area in both periods. After 7\u2009days, SB was the only group similar to the C group regarding the number of axons; furthermore, after 30\u2009days, the SB group was closer to the C group concerning blood vessel and central myonuclear numbers, NMJ angle, and connective tissue volume. After 7\u2009days, increases in nerve area, as well as the number and area of blood vessels, were also observed in SB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>HFB potentiates the immune response, increases axonal regeneration, induces angiogenesis, prevents severe muscle degeneration, and assists in NMJ recovery. In conclusion, suture\u2010associated HFB has major implications for improved peripheral nerve repair.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mus.27815","type":"journal-article","created":{"date-parts":[[2023,3,11]],"date-time":"2023-03-11T08:47:04Z","timestamp":1678524424000},"page":"522-536","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Neuroregeneration and immune response after neurorrhaphy are improved with the use of heterologous fibrin biopolymer in addition to suture repair alone"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2660-6089","authenticated-orcid":false,"given":"Felipe Cantore","family":"Tib\u00farcio","sequence":"first","affiliation":[{"name":"S\u00e3o Paulo State University (Unesp)  Medical School Botucatu S\u00e3o Paulo Brazil"},{"name":"Division of Anatomy, Department of Structural and Functional Biology S\u00e3o Paulo State University (Unesp)  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