Clinical Use of Nerve Conduits in Peripheral-Nerve Repair: Review of the Literature

Meek, Marcel F.; Coert, J. Henk

doi:10.1055/s-2002-19889

Cited by 234 publications

(188 citation statements)

References 48 publications

(63 reference statements)

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“…The majority of these devices have been variations of hollow conduits, designed to guide regenerating axons toward the distal nerve stump [2,17,30]. Most clinical studies have examined the use of these nerve conduits for sensory nerve gaps of 20 mm or less [9,22]. Weber et al have reported their results after using a polyglycolic acid nerve conduits for the treatment of nerve injuries distal to the wrist crease.…”

Section: Discussionmentioning

confidence: 99%

Early Clinical Outcomes with the Use of Decellularized Nerve Allograft for Repair of Sensory Defects within the Hand

Karabekmez

Duymaz

Moran

2009

Hand (New York, N,Y.)

225

146

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Nerve conduits have become an established option for repair of sensory deficits of up to 2 cm. More recently, decellularized nerve allograft has also been advocated as an option for nerve repair; however, no clinical studies have examined its efficacy for the treatment of sensory nerve defects. The aim of this study was to examine our early experience with the use of decellularized nerve allograft for repair of segmental nerve defects within the hand and fingers. From July 2007 to March 2008, seven patients who had ten nerve gaps were treated surgically using decellularized nerve allograft. Eight digital and two dorsal sensory nerves were repaired. The etiologies of the nerve defects were traumatic nerve transection in eight defects and neuroma resection and reconstruction in two defects. All of the affected nerves were pure sensory fibers. Functional recovery was evaluated by blinded hand therapist using moving and static two point discrimination tests. Implantation sites were also evaluated for any signs of infection, rejection, or graft extrusion. There were five men and two women with a mean age of 44 years (range 23-65). Mean nerve graft length was 2.23 cm with a range of 0.5-3 cm. Mean follow up time was 9 months (range 5-12). Average two point discrimination was 4.4 mm moving and 5.5 mm static at last recorded follow-up. There were no wound infections observed around the graft material and sensory improvement was observed in all of the patients despite this short-term follow-up. Re-exploration of two fingers was required for flexor tendon rupture in one and flexor tendon tenolysis in the other. In both cases, the nerve allograft was visualized and appeared well incorporated in the repair site. Decellularized nerve allografts were capable of returning adequate sensation in nerve defects ranging from 0.5 to 3 cm. There were no cases of infection or rejection. Decellularized nerve allograft may provide an option for segmental nerve gaps beyond 2 cm. Randomized comparative studies will be required to determine efficacy in comparison to collagen conduits or nerve autograft.

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Section: Discussionmentioning

confidence: 99%

Early Clinical Outcomes with the Use of Decellularized Nerve Allograft for Repair of Sensory Defects within the Hand

Karabekmez

Duymaz

Moran

2009

Hand (New York, N,Y.)

225

146

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“…Several clinical studies have documented the effectiveness of nerve conduits for short gaps (9); however, the clinical value of nerve conduits to bridge larger gaps remains unclear. (3,9) Recent advances in allograft tissue processing have eliminated the need for immunosuppression, and allografts are becoming an attractive alternative to autografts and conduits. (10,11,12) Several authors have reported success with processed nerve allografts.…”

Section: Introductionmentioning

confidence: 99%

Allograft Reconstruction for Digital Nerve Loss

Taras¹,

Amin²,

Patel³

et al. 2013

The Journal of Hand Surgery

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“…Substantially larger segmental defects could be reconstructed, and the morbidity of harvesting would be eliminated. Several types of materials have been proposed as peripheral nerve substitutes [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15], including autologous materials such as vein and muscle strips, synthetic materials such as polylactic acid and polyglycolic acid, non-autologous biological materials such as acellular peripheral nerve allograft, and conduits made of collagen, laminin, fibronectin, and alginate.…”

Section: Introductionmentioning

confidence: 99%

Mechanical properties of acellular peripheral nerve

Borschel

Kia

Kuzon

et al. 2003

Journal of Surgical Research

243

165

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Background. Acellular nerve has been used in experimental models as a peripheral nerve substitute. Our objective was to determine the difference in tensile strength between fresh and chemically treated acellularized peripheral nerve.Materials and methods. F344 rat sciatic nerves were either fresh or acellularized and tested either whole (Part A) or transected and repaired (Part B). For all constructs, the mean ultimate stress, mean ultimate strain, Young's modulus, and total mechanical work to fracture were calculated.Results Conclusions. Although adequately robust for reconstructive procedures, the acellular peripheral nerve had decreased tensile strength compared with fresh nerve either when tested whole or when transected and repaired.

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Clinical Use of Nerve Conduits in Peripheral-Nerve Repair: Review of the Literature

Abstract: The use of nerve conduits has evolved from a previous experimental idea to a clinical reality over the last ten years. An overview of the literature on the clinical use of nerve conduits in peripheral-nerve repair is presented.

Cited by 234 publications

References 48 publications

Early Clinical Outcomes with the Use of Decellularized Nerve Allograft for Repair of Sensory Defects within the Hand

Early Clinical Outcomes with the Use of Decellularized Nerve Allograft for Repair of Sensory Defects within the Hand

Allograft Reconstruction for Digital Nerve Loss

Mechanical properties of acellular peripheral nerve

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