Bioengineered nerve conduits and wraps for peripheral nerve repair of the upper limb

Thomson, Sydney; Ng, Nigel Y B; Riehle, Mathis; Kingham, Paul J.; Dahlin, Lars B.; Wiberg, Mikael; Hart, Andrew

doi:10.1002/14651858.cd012574.pub2

Cited by 10 publications

(8 citation statements)

References 74 publications

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“…Finger sensory function evaluation: Finger sensory recovery is divided into 5 levels according to the evaluation standard of the British Medical Research Association. [ 3 ] Grade S4: finger sensation returned to normal, 2-point resolution < 6 mm; Grade S3: recovery of finger touch and superficial sensation, and existence of 2-point discrimination; S2 grade: slight recovery of superficial sensation of fingers; S1 grade: finger skin pain recovery; Grade S0: no sensation in fingers.…”

Section: Methodsmentioning

confidence: 99%

Practical study on the application of full-cycle fast track surgical nursing model in patients with replantation of severed fingers: A retrospective analysis

Ju,

Li,

Wang

et al. 2023

Medicine

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To explore the effect of full-cycle fast track surgical (FTS) nursing in patients with replantation of severed fingers, and observe its effect on functional recovery of replanted fingers and quality of life of patients. From January 2021 to December 2022, 86 patients with replantation of severed fingers were selected from Rizhao People’s Hospital, 41 patients were given routine perioperative care, 45 patients were given full-cycle rapid rehabilitation surgical care. Compare the relevant indexes of the 2 groups of patients during hospitalization. Three months after discharge, the finger function recovery of the 2 groups were compared, and the quality of life of the patients was scored with the QL-Index scale, and the satisfaction was evaluated at the same time. The first time of getting out of bed and the time of hospitalization in the full-cycle FTS nursing group were significantly shorter than those in the conventional nursing group, and the incidence of postoperative nausea, vomiting, constipation and venous thromboembolism were significantly lower than those in the conventional nursing group. The anxiety score was significantly lower than that in the conventional nursing group, the difference was statistically significant (P < .05). There was no significant difference in the incidence of arteriovenous crisis between the 2 groups (P > .05). Three months after discharge, the scores of finger sensation and movement, quality of life and satisfaction of patients in the FTS nursing group were higher than those in the conventional nursing group, and the difference was statistically significant (P < .05). Full-cycle fast track surgical nursing model can improve the in-patient experience, reduce the incidence of complications, promote rapid rehabilitation, improve the quality of life of patients, and improve satisfaction.

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Section: Methodsmentioning

confidence: 99%

Practical study on the application of full-cycle fast track surgical nursing model in patients with replantation of severed fingers: A retrospective analysis

Ju,

Li,

Wang

et al. 2023

Medicine

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“…Although the Food and Drug Administration had approved several off-the-shelf synthetic nerve conduits on the market, but most of them are limited to nerve gaps <3 cm or <0.5 cm in small or large diameter nerves, respectively ( de Ruiter et al, 2009 ). In addition, a recent review does not support the use of currently available TENG over standard nerve repair ( Thomson et al, 2022 ). To achieve a better outcome in longer nerve gaps, nerve allografts are harvested and processed under a commercial decellularization process.…”

Section: Introductionmentioning

confidence: 99%

Physical processing for decellularized nerve xenograft in peripheral nerve regeneration

Hsu

Chen

Tseng

et al. 2023

Front. Bioeng. Biotechnol.

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In severe or complex cases of peripheral nerve injuries, autologous nerve grafts are the gold standard yielding promising results, but limited availability and donor site morbidity are some of its disadvantages. Although biological or synthetic substitutes are commonly used, clinical outcomes are inconsistent. Biomimetic alternatives derived from allogenic or xenogenic sources offer an attractive off-the-shelf supply, and the key to successful peripheral nerve regeneration focuses on an effective decellularization process. In addition to chemical and enzymatic decellularization protocols, physical processes might offer identical efficiency. In this comprehensive minireview, we summarize recent advances in the physical methods for decellularized nerve xenograft, focusing on the effects of cellular debris clearance and stability of the native architecture of a xenograft. Furthermore, we compare and summarize the advantages and disadvantages, indicating the future challenges and opportunities in developing multidisciplinary processes for decellularized nerve xenograft.

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“…Studies indicate that the results after nerve reconstruction with conduits work best when the defect is less than 3 cm. [25][26][27][28][29] Although not a gold standard treatment, as reconstruction with nerve autograft, nerve conduits have been on the market since the early 1990s, and extensive research on outcomes can be found in the literature. 11,30 A newer, and principally interesting, alternative to autologous nerve grafting and artificial conduits is the use of a processed nerve allograft (PNA), which is a commercially available product manufactured and marketed as Avance Nerve Graft by Axogen Corporation (https:// axogeninc.eu/avance-nerve-graft/).…”

Section: Introductionmentioning

confidence: 99%

“…Studies indicate that the results after nerve reconstruction with conduits work best when the defect is less than 3 cm. 25–29 Although not a gold standard treatment, as reconstruction with nerve autograft, nerve conduits have been on the market since the early 1990s, and extensive research on outcomes can be found in the literature. 11,30…”

Section: Introductionmentioning

confidence: 99%

“…One commonly used alternative is the use of commercially available collagen or polymer nerve conduits. 11 , 25 The ends of the injured nerve are inserted into the conduit, thereby facilitating the growth of the axons from the proximal nerve end toward the distal part of the nerve. Studies indicate that the results after nerve reconstruction with conduits work best when the defect is less than 3 cm.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Processed Nerve Allograft in Peripheral Nerve Surgery: A Systematic Review and Critical Appraisal

Frostadottir

Chemnitz

Johansson

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Peripheral nerve injuries cause substantial problems when not treated properly. A specific problem is reconstruction of nerve defects, which can be treated in different ways. This study aimed to systematically review whether processed nerve allograft (PNA) is justified in reconstruction of a nerve defect in patients after posttraumatic or iatrogenic peripheral nerve injury and to compare PNA with other established methods. Methods: A systematic review with a focused question, PICO (patient, intervention, comparison, outcome) and constraints, was performed. A structured literature search, including several databases, was done to evaluate the existing evidence for outcomes and postoperative complications related to PNA. The certainty of evidence was classified according to Grading of Recommendations, Assessment, Development and Evaluations. Results: No conclusions, concerning differences in outcome of nerve reconstruction using PNA compared with the use of nerve autograft or conduits, could be drawn. The level of certainty for all evaluated outcomes was very low (⊕◯◯◯). Most published studies lack a control group to patients treated with PNA; being only descriptive, making it difficult to compare PNA with established methods without substantial risk of bias. For studies including a control group, the scientific evidence was of very low certainty, due to a low number of included patients, and large, undefined loss of patients during follow-up, rendering a high risk of bias. Finally, the authors often had financial disclosures. Conclusion: Properly conducted randomized controlled trial studies on the use of PNA in reconstruction of peripheral nerve injuries are needed to establish recommendations in clinical practice.

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Bioengineered nerve conduits and wraps for peripheral nerve repair of the upper limb

Cited by 10 publications

References 74 publications

Practical study on the application of full-cycle fast track surgical nursing model in patients with replantation of severed fingers: A retrospective analysis

Practical study on the application of full-cycle fast track surgical nursing model in patients with replantation of severed fingers: A retrospective analysis

Physical processing for decellularized nerve xenograft in peripheral nerve regeneration

Evaluation of Processed Nerve Allograft in Peripheral Nerve Surgery: A Systematic Review and Critical Appraisal

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