Management of nerve gaps: Autografts, allografts, nerve transfers, and end-to-side neurorrhaphy

Scaffolds for Peripheral Nerve Regeneration, the Importance of In Vitro and In Vivo Studies for the Development of Cell-Based Therapies and Biomaterials: State of the Art

“…Xenografts have been described as viable alternatives but require extensive immunosuppression and prionic diseases transmission if they are from ruminants [72,73]. Nerve autografts are considered the gold standard since they provide appropriate neurotrophic factors and viable SCs, both essential for axonal regeneration without immune compromise [63,74]. For the choice of the autologous grafts, many factors must be taken into account, such as the size of the nerve gap, the location of proposed nerve repair and associated donor-site morbidity [63,74].…”

“…Nerve autografts are considered the gold standard since they provide appropriate neurotrophic factors and viable SCs, both essential for axonal regeneration without immune compromise [63,74]. For the choice of the autologous grafts, many factors must be taken into account, such as the size of the nerve gap, the location of proposed nerve repair and associated donor-site morbidity [63,74]. Grafts are either sutured to the epineurium of single nerves or more commonly to the perineurium of individual fascicles, depending on nerve calibre, type and location [30,63,74].…”

“…For the choice of the autologous grafts, many factors must be taken into account, such as the size of the nerve gap, the location of proposed nerve repair and associated donor-site morbidity [63,74]. Grafts are either sutured to the epineurium of single nerves or more commonly to the perineurium of individual fascicles, depending on nerve calibre, type and location [30,63,74]. The interfascicular nerve graft was described by Millesi et al [75].…”

Functional Recovery following an End to Side Neurorrhaphy of the Accessory Nerve to the Suprascapular Nerve: Case Report

“…The precise mechanism of axonal regeneration following end-to-side neurrorhaphy remains controversial with both experimental and clinical studies reporting mixed results [4,6,8,11,12,19,20,[23][24][25][33][34][35][36][37]. Several authors have concluded that axonal damage to the donor nerve is required to induce motor collateral sprouting but may not be required to induce sensory sprouting in end-to-side neurorrhaphy [1,12,28,29].…”

Sekundäre Nervenrekonstruktionen

“…Die beste Methode der primären Nervenrekonstruktion ist die direkte, spannungsfreie End-zu-End-Neuroraphie [11]. Nach Präparation der Nervenstümpfe und sparsamem Anfrischen erfolgt die Approximation mit möglichst exakter Identifizierung der korrespondierenden Faszikel.…”