Regeneration of Peripheral Nerve Gaps with a Polyglycolic Acid-Collagen Tube

Inada, Yûji; Morimoto, Shigeru; Takakura, Yoshinori; Nakamura, Tatsuo

doi:10.1227/01.neu.0000134388.86603.11

Cited by 74 publications

(33 citation statements)

References 24 publications

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“…2 PEG solution therapy combined with nerve tubes demonstrates a statistically significant improvement in foot fault asymmetry score at weeks 1, 2, and 3 (p=0.007, p=0.01, and p=0.006 two-tailed t test). N=8 for PEG group and N=7 for control group Nerve tubes were selected for use in comparison to microsuture because collagen conduits have demonstrated improved regeneration when utilized to repair nerve gaps [9,12,23,26,30]. For the purposes of this study, we used a collagen tube to prevent microsuture placement at the site of nerve repair and as a conduit for delivery of solutions.…”

Section: Discussionmentioning

confidence: 99%

Axonal Fusion via Conduit-Based Delivery of Hydrophilic Polymers

Sexton

Rodriguez-Feo

Boyer

et al. 2015

Hand (New York, N,Y.)

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Background Hydrophilic polymers have been shown to improve physiologic recovery following repair of transected nerves with microsutures. Our study was designed to combine hydrophilic polymer therapy with nerve tubes (NT) to enhance polymer delivery to the site of nerve injury. Methods Using a rat sciatic nerve injury model, a single transection injury was repaired in an end-to-end fashion with NT+polyethylene glycol (PEG) to NT alone. Compound action potentials (CAPs) were recorded before nerve transection and after repair. Behavioral testing was performed for 5 weeks. Results PEG therapy restored CAPS in all, but one, animals, while no CAPS were recorded in animals not receiving PEG. Behavioral nerve function was measured using the standardized functional assessment technique and foot fault asymmetry scores (FF). FF scores were improved for the PEG therapy groups on postoperative days 7, 14, and 21. However, after expected eventual axonal outgrowth, the benefit was less noticeable at days 28 and 35. Immunohistochemistry of the distal axon segments showed an increase number of sensory and motor axons in the NT+PEG group as compared to NT alone.Conclusion These data suggest that PEG delivery via a conduit may provide a simple, effective way to fuse severed axons and regain early nerve function. For proximal nerve injuries in large animals, recovery of axonal continuity could dramatically improve outcomes, even if fusion only occurs in a small percentage of axons.

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Section: Discussionmentioning

confidence: 99%

Axonal Fusion via Conduit-Based Delivery of Hydrophilic Polymers

Sexton

Rodriguez-Feo

Boyer

et al. 2015

Hand (New York, N,Y.)

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“…However, this complication can be prevented by providing a healthy soft tissue at the site of repair site. 8,76,83,86,87,91,101,115,160,167 Polyesters and copolyesters. Aliphatic polyesters and copolyesters have been reported as suitable for nerve regeneration.…”

Section: Biodegradable Synthetic Materialsmentioning

confidence: 99%

“…178 The vein conduits filled with collagen provide successful results in the nerve defects of 15 mm in rabbits. 160,178 In rabbit model using muscle-vein scaffolds, successful nerve regeneration was obtained in a defect length of 55 mm. 172,178 Since the results of silicone-used scaffolds are not optimum, the biodegradable materials are mostly preferred.…”

Section: Intraluminal Conduit Components/scaffoldsmentioning

confidence: 99%

Regeneration and repair of peripheral nerves with different biomaterials: Review

2010

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Peripheral nerve injury may cause gaps between the nerve stumps. Axonal proliferation in nerve conduits is limited to 10-15 mm. Most of the supportive research has been done on rat or mouse models which are different from humans. Herein we review autografts and biomaterials which are commonly used for nerve gap repair and their respective outcomes. Nerve autografting has been the first choice for repairing peripheral nerve gaps. However, it has been demonstrated experimentally that tissue engineered tubes can also permit lead to effective nerve repair over gaps longer than 4 cm repair that was previously thought to be restorable by means of nerve graft only. All of the discoveries in the nerve armamentarium are making their way into the clinic, where they are, showing great potential for improving both the extent and rate of functional recovery compared with alternative nerve guides.

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“…Inzwischen sind mehrere Produkte aus verschiedenen synthetischen, vom Körper abbaubaren Materialien zum klinischen Einsatz zugelassen und deren Verwendung in unterschiedlichem Umfang publiziert [2,3,4,5,6,11,12,16,22,25,29]. Die Ergebnisse dieser Publikationen werden in dieser Arbeit zusammengefasst und unseren eigenen Erfahrungen gegenübergestellt.…”

Section: üBerbrückung Peripherer Nervendefekte Durch Den Einsatz Von unclassified