Autogenous Vein Graft Repair of Digital Nerve Defects in the Finger

Walton, Robert L.; Brown, Richard E.; Matory, W. Earle; Borah, Gregory; Dolph, James L.

doi:10.1097/00006534-198912000-00013

Cited by 109 publications

(24 citation statements)

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“…A detailed overview concerning the selection process is shown in Figure 1. Those remaining 2,997 digital nerve repairs provided the basis for further analysis (Table 2 [3, 25, 34–48], Table 3 [8–12], Table 4 [3, 25, 36, 40, 43, 48–57], Table 5 [14, 58–64], Table 6 [36, 45, 56, 65–68], Table 7 [19, 37, 64, 69–71], and Table 8 [25, 72–77]). Some case reports, which were excluded from the meta-analysis to lower heterogeneity regarding the given sensory recovery outcomes, are nevertheless shown in Tables 2–8.…”

Section: Resultsmentioning

confidence: 99%

Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

Paprottka

Wolf

Harder

et al. 2013

Plastic Surgery International

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Good clinical outcome after digital nerve repair is highly relevant for proper hand function and has a significant socioeconomic impact. However, level of evidence for competing surgical techniques is low. The aim is to summarize and compare the outcomes of digital nerve repair with different methods (end-to-end and end-to-side coaptations, nerve grafts, artificial conduit-, vein-, muscle, and muscle-in-vein reconstructions, and replantations) to provide an aid for choosing an individual technique of nerve reconstruction and to create reference values of standard repair for nonrandomized clinical studies. 87 publications including 2,997 nerve repairs were suitable for a precise evaluation. For digital nerve repairs there was practically no particular technique superior to another. Only end-to-side coaptation had an inferior two-point discrimination in comparison to end-to-end coaptation or nerve grafting. Furthermore, this meta-analysis showed that youth was associated with an improved sensory recovery outcome in patients who underwent digital replantation. For end-to-end coaptations, recent publications had significantly better sensory recovery outcomes than older ones. Given minor differences in outcome, the main criteria in choosing an adequate surgical technique should be gap length and donor site morbidity caused by graft material harvesting. Our clinical experience was used to provide a decision tree for digital nerve repair.

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Section: Resultsmentioning

confidence: 99%

Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

Paprottka

Wolf

Harder

et al. 2013

Plastic Surgery International

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“…The interest in this surgical procedure revived in the 1980s with the experimental demonstration that vein grafting was capable of fostering nerve repairs comparable to autogenous nerve grafting. 22,30,31 The clinical studies published by Walton et al 32 and Chiu and Strauch 33 on sensory nerve repair by means of vein grafts reported satisfactory return of sensibility, comparable to the nerve grafting technique. Although the efficacy of vein grafts for bridging nerve gaps was confirmed, 12,19,34,35 both experimental and clinical studies showed that vein grafts were effective only for relatively short gaps (less than 30 mm).…”

Section: Biologic Tubesmentioning

confidence: 95%

Nerve repair by means of tubulization: Literature review and personal clinical experience comparing biological and synthetic conduits for sensory nerve repair

et al. 2005

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Nerve repair is usually accomplished by direct suture when the two stumps can be approximated without tension. In the presence of a nerve defect, the placement of an autologous nerve graft is the current gold standard for nerve restoration. However, over the last 20 years, an increasing number of research articles reported on the use of non-nervous tubes (tubulization) for repairing nerve defects. The clinical employment of tubes (both biological and synthetic) as an alternative to autogenous nerve grafts is mainly justified by the limited availability of donor tissue for nerve autografts and the related morbidity. In addition, tubulization was proposed as an alternative to direct nerve sutures in order to create optimal conditions for nerve regeneration over the short empty space intentionally left between two nerve stumps. This paper outlines recent important advances in this field. Different tubulization techniques proposed so far are described, focusing in particular on studies that reported on the employment of tubes with patients. Our personal clinical experience on tubulization repair of sensory nerve lesions (digital nerves), using both biological and synthetic tubes, is presented, and the clinical results are compared. In our case series, both types of tubes led to good clinical results. Finally, we speculate about the prospects in the clinical application of tubulization for peripheral nerve repair.

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“…21-28 A donor site is not necessary. Several materials have been used for this purpose, ranging from biological in origin [29][30][31][32][33][34][35] to nondegradable 26,[36][37][38] and degradable 39-46 materials.…”

Section: Introductionmentioning

confidence: 99%

Use of Skeletal Muscle Tissue in Peripheral Nerve Repair: Review of the Literature

Meek¹,

Varejão

Geuna

2004

Tissue Engineering

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The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, necessitates a donor nerve and corresponding deficit. Many alternative techniques have thus been developed. The use of skeletal muscle tissue as graft material for nerve repair is one example. The rationale regarding the use of the skeletal muscle tissue technique is the availability of a longitudinally oriented basal lamina and extracellular matrix components that direct and enhance regenerating nerve fibers. These factors provide superiority over other bridging methods as vein grafts or (non)degradable nerve conduits. The main disadvantages of this technique are the risk that nerve fibers can grow out of the muscle tissue during nerve regeneration, and that a donor site is necessary to harvest the muscle tissue. Despite publications on nerve conduits as an alternative for peripheral nerve repair, autologous nerve grafting is still the standard care for treatment of a nerve gap in the clinical situation; however, the use of the skeletal muscle tissue technique can be added to the surgeon's arsenal of peripheral nerve repair tools, especially for bridging short nerve defects or when traditional nerve autografts cannot be employed. This technique has been investigated both experimentally and clinically and, in this article, an overview of the literature on skeletal muscle grafts for bridging peripheral nerve defects is presented.

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Autogenous Vein Graft Repair of Digital Nerve Defects in the Finger

Cited by 109 publications

References 0 publications

Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

Sensory Recovery Outcome after Digital Nerve Repair in Relation to Different Reconstructive Techniques: Meta-Analysis and Systematic Review

Nerve repair by means of tubulization: Literature review and personal clinical experience comparing biological and synthetic conduits for sensory nerve repair

Use of Skeletal Muscle Tissue in Peripheral Nerve Repair: Review of the Literature

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