Nerve repair by means of vein filled with muscle grafts. II. Morphological analysis of regeneration

Battiston, Bruno; Tos, Pierluigi; Geuna, Stefano; Giacobini-Robecchi, Maria G.; Guglielmone, R

doi:10.1002/(sici)1098-2752(2000)20:1<37::aid-micr7>3.0.co;2-5

Cited by 94 publications

(55 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,4 Experimen-tal research on rat demonstrated that filling the veins with fresh muscle fibers allow to obtain nerve regeneration that similar to that observed with nerve autografting. 22,23 Muscle fibers avoid conduit's collapse and promote axo-nal regeneration and Schwann cell migration by means of basal lamina scaffolds. 24,25 However, a further element that may explain the positive effects of grafted skeletal muscle fibers on the regenerating nerve fibers arises from the recent demonstration that muscle fibers and Schwann cells share a common autotrophic loop based on the neu-regulin/ErbB receptor signaling pathway.…”

Section: Discussionmentioning

confidence: 99%

Primary repair of crush nerve injuries by means of biological tubulization with muscle‐vein‐combined grafts

Tos¹,

Battiston²,

Ciclamini³

et al. 2012

Microsurgery

Self Cite

View full text Add to dashboard Cite

Despite extensive research and surgical innovation, the treatment of peripheral nerve injuries remains a complex issue, particularly in nonsharp lesions. The aim of this study was to assess the clinical outcome in a group of 16 patients who underwent, in emergency, a primary repair for crush injury of sensory and mixed nerves of the upper limb with biological tubulization, namely, the muscle-vein-combined graft. The segments involved were sensory digital nerves in eight cases and mixed nerves in another eight cases (four median nerves and four ulnar nerves). The length of nerve defect ranged from 0.5 to 4 cm (mean 1.9 cm). Fifteen of 16 patients showed some degree of functional recovery. Six patients showed diminished light touch (3.61), six had protective sensation (4.31), and three showed loss of protective sensation (4.56) using Semmes-Weinstein monofilament test. All the patients who underwent digital nerve repair had favorable results graded as S4 in one case, S3þ in six cases, and S3 in one case. With respect to mixed nerve repair, we observed two S4, two S3þ, two S3, one S2, and one S0 sensory recovery. Less favorable results were observed for motor function with three M4, one M3, two M2, and two M0 recoveries. Altogether, the results of this retrospective study demonstrates that tubulization nerve repair in emergency, in case of short nerve gaps, may restore the continuity of the nerve avoiding secondary nerve grafting. This technique preserves donor nerve and, in case of failure, does not preclude a delayed repair with a nerve graft.Despite continuous researches and surgical innovations, the treatment of peripheral nerve injuries remains a com-plex problem. 1,2 Direct nerve repair is often impossible in case of loss of substance, thus requiring a different solu-tion to manage the gap. Nowadays, nerve autograft is still considered the ''gold standard'' for such lesions because it restores the continuity of nerve trunk without tension and offers and ideal support to regenerating axons. 2-7 A nerve autograft is rich of Schwann cells which have a major role in nerve repair due to basal membrane pro-teins (fibronectin and laminin) that promote and address axonal regeneration. [8][9][10][11] However, clinical outcome is often unsatisfactory and thus alternative types of nerve guides are sought. 1,5,12 The timing of intervention and the type of injury are major issues in nerve repair. As general rule, an open nerve injury should be early treated and repaired directly when optimal conditions, such as a) a clean-uncontami-nated wound and b) a sharp cut injury, are present. 12 Pri-mary nerve repair with nerve graft in crush injuries could be a risk because the extent of resection might be diffi-cult to judge in case of nerve laceration and contusion; in addition, sometimes it is better to avoid primary repair because of the conditions of the surrounding tissues. 13 In these circumstances, it may be advisable to identify and suture the nerve ends to avoid retraction, and then look-ing forward to a secondary recons...

show abstract

Section: Discussionmentioning

confidence: 99%

Primary repair of crush nerve injuries by means of biological tubulization with muscle‐vein‐combined grafts

Tos¹,

Battiston²,

Ciclamini³

et al. 2012

Microsurgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…The idea of employing muscle fibers for axonal regeneration is on the similarities between the muscle basal lamina and the endoneurial tubes (Fawcett & Keynes, 1990;Glasby, Gschmeissner, Hitchcock, & Huang, 1986). Finally, a combined conduit by enriching vein segments with fresh skeletal muscle fibers (muscle-in-vein conduit) is used to improve effectiveness of tubulization nerve repair (Battiston, Tos, Cushway, & Geuna, 2000;Battiston, Tos, Geuna, Giacobini-Robecchi, & Guglielmone, 2000;Brunelli, Battiston, Vigasio, Brunelli, & Marocolo, 1993;Fornaro, Tos, Geuna, Giacobini-Robecchi, & Battiston, 2001;Tos, Battiston, Ciclamini, Geuna, & Artiaco, 2012). iii.…”

Section: Changes At the Nerve Levelmentioning

confidence: 99%

Future Perspectives in Nerve Repair and Regeneration

Tos

Ronchi

Geuna

et al. 2013

International Review of Neurobiology

Self Cite

View full text Add to dashboard Cite

After peripheral nerve injuries, the process of nerve regeneration and target reinnervation is very complex and depends on many different events occurring not only at the lesion site but also proximally and distally to it. In spite of the recent scientific and technological advancements, the need to find out new strategies to improve clinical nerve repair and regeneration remains. To reach this goal, the therapeutic strategy shouldthusexertitseffectsatdifferentlevelsinordertosimultaneouslypotentiateaxonal regeneration, increase neuronal survival, modulate central reorganization, and inhibitorreducetargetorganatrophy.Itisexpectedthatthismultilevelapproachmight leadtosignificantimprovementinthefunctionaloutcomeandthusthequalityoflifeof the patients suffering from peripheral nerve injury.

show abstract

“…[2,3] Autogenous nerve grafts can lead to donor site morbidity. [2,[4][5][6] Use of this tissue [18,19] to prevent graft collapse, and this combined technique is effective for defects of less than 3 cm.…”

Section: Introductionmentioning

confidence: 99%

A Biological Tube Technique For The Repair Of Peripheral Nerve Defects Using ‘Stuffed Nerves’

Çapkın¹,

Akhisaroğlu²,

Ergür³

et al. 2016

Ulus Travma Acil Cerrahi Derg

View full text Add to dashboard Cite

show abstract

Nerve repair by means of vein filled with muscle grafts. II. Morphological analysis of regeneration

Cited by 94 publications

References 13 publications

Primary repair of crush nerve injuries by means of biological tubulization with muscle‐vein‐combined grafts

Primary repair of crush nerve injuries by means of biological tubulization with muscle‐vein‐combined grafts

Future Perspectives in Nerve Repair and Regeneration

A Biological Tube Technique For The Repair Of Peripheral Nerve Defects Using ‘Stuffed Nerves’

Contact Info

Product

Resources

About