Biological and Synthetic Conduits in Peripheral Nerve Repair: A Comparative Experimental Study

Giardino, Roberto; Aldini, N. Nicoli; Perego, G.; Cella, Gian Domenico; Maltarello, Maria Cristina; Fini, Milena; Rocca, Michele; Giavaresi, G.

doi:10.1177/039139889501800408

Cited by 33 publications

(11 citation statements)

References 9 publications

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“…26 Biodegradable nerve guides potentially provide a successful alternative. 1,27,28 The objective of using biodegradable p(DLLA-⑀-CL) nerve guides is that the nerve guide degrades after guiding the regenerating nerve fibres towards the distal nerve stump. This generally prevents the formation of a neuroma-in-continuity and ingrowth of fibrous tissue.…”

Section: Discussionmentioning

confidence: 99%

“…One alternative to eliminate these problems is to use biodegradable nerve guides. 1 After functioning as a temporary scaffold for nerve regeneration, they gradually degrade. Using a biodegradable nerve guide composed of an amorphous copolymer of DL-lactide and ⑀-caprolactone [p(DLLA-⑀-CL)] has proven to be effective in rats in case of a 1-cm nerve gap.…”

Section: Microsurgery 19:381-388 1999mentioning

confidence: 99%

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Functional assessment of sciatic nerve reconstruction: Biodegradable poly (DLLA-?-CL) nerve guides versus autologous nerve grafts

Meek¹,

Dijkstra²,

Dunnen³

et al. 1999

Microsurgery

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The aim of this study was to compare functional nerve recovery after reconstruction with a biodegradable p(DLLA-epsilon-CL) nerve guide filled with modified denatured muscle tissue (MDMT), or an autologous nerve graft. We evaluated nerve recovery using walking track analysis (measurement of the sciatic function index [SFI]) and electrostimulation tests. Functional nerve recovery after reconstruction with a biodegradable p(DLLA-epsilon-CL) nerve guide filled with MDMT was faster when compared with nerve reconstruction using an autologous nerve graft. We conclude that in case of a short nerve gap in the rat, reconstruction can best be carried out using a p(DLLA-epsilon-CL) biodegradable nerve guide filled with MDMT.

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Section: Discussionmentioning

confidence: 99%

Section: Microsurgery 19:381-388 1999mentioning

confidence: 99%

Functional assessment of sciatic nerve reconstruction: Biodegradable poly (DLLA-?-CL) nerve guides versus autologous nerve grafts

Meek¹,

Dijkstra²,

Dunnen³

et al. 1999

Microsurgery

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show abstract

“…One successful alternative to eliminate these problems is the use of biodegradable nerve guides. [1][2][3] After functioning as a temporary scaffold for nerve regeneration, they gradually degrade. The use of a biodegradable nerve guide composed of an amorphous copolymer of DL-lactide and -caprolactone [p(DLLA--CL)] has proven to be effective.…”

mentioning

confidence: 99%

Long-term evaluation of functional nerve recovery after reconstruction with a thin-walled biodegradable poly (DL-Lactide-?-caprolactone) nerve guide, using walking track analysis and electrostimulation tests

Meek¹,

Dunnen

Schakenraad³

et al. 1999

Microsurgery

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This study was performed to evaluate the long-term functional nerve recovery after reconstruction of a 10-mm gap in the sciatic nerve of the rat, with a thin-walled nerve guide, composed of a biodegradable copolymer of DL-lactide and epsilon-caprolactone [p(DLLA-epsilon-CL)]. To evaluate both motor and sensory nerve recovery, walking track analysis and electrostimulation tests were carried out after implantation periods ranging from 3 to 52 weeks postoperatively. The first signs of both motor and sensory nerve recovery could be observed after 5 weeks. After 15 weeks, 70% of the sciatic function and 90% of the sensory nerve function had been recovered. After this period, the sciatic function index (SFI) did not improve further, whereas the sensory nerve function appeared to return to normal. When the results of the SFI measurements, minus those obtained from rats with severe automutilation, are extrapolated, further improvement of the SFI might be expected after 52 weeks. The fact that 100% sensory nerve recovery was obtained, as measured by the electrostimulation test, could be explained by sensory reinnervation from surrounding areas. The SFI was not fully reestablished because automutilation had a great impact on the use of walking track assessment.

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“…Significant attention has thus been directed towards development of nerve guides or conduits based on allografts, xenografts and various bioresorbable or non-resorbable synthetic polymers in order to improve the prognosis for repair of damaged nerves in the PNS and avoid the loss of neural function caused by harvesting sensory nerve autografts [10][11][12][13][14][15][16][17][18]. Universally, the design of such nerve repair conduits aims to facilitate a neurotrophic environment that allows proper growth and reconnection of regenerating (damaged) axons with the distal end of the damaged nerve.…”

Section: Introductionmentioning

confidence: 99%

Engineering a multimodal nerve conduit for repair of injured peripheral nerve

et al. 2013

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Injury to nerve tissue in the peripheral nervous system (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss of sensation from the tissue innervated by the harvested nerve. The challenges that persist with nerve repair have resulted in development of nerve guides or conduits from non-neural biological tissues and various polymers to improve the prognosis for the repair of damaged nerves in the PNS. This study describes the design and fabrication of a multimodal controlled pore size nerve regeneration conduit using polylactic acid (PLA) and (PLA):poly(lactic-coglycolic) acid (PLGA) fibers within a neurotrophin-enriched alginate hydrogel. The nerve repair conduit design consists of two types of PLGA fibers selected specifically for promotion of axonal outgrowth and Schwann cell growth (75:25 for axons; 85:15 for Schwann cells). These aligned fibers are contained within the lumen of a knitted PLA sheath coated with electrospun PLA nanofibers to control pore size. The PLGA guidance fibers within the nerve repair conduit lumen are supported within an alginate hydrogel impregnated with neurotrophic factors (NT-3 or BDNF with LIF, SMDF and MGF-1) to provide neuroprotection, stimulation of axonal growth and Schwann cell migration. The conduit was used to promote repair of transected sciatic nerve in rats over a period of 4 weeks. Over this period, it was observed that over-grooming and self-mutilation (autotomy) of the limb implanted with the conduit was significantly reduced in rats implanted with the full-configuration conduit compared to rats implanted with conduits containing only an alginate hydrogel. This indicates return of some feeling to the limb via the fully-configured conduit. Immunohistochemical analysis of the implanted conduits removed from the rats after the four-week implantation period confirmed the presence of myelinated axons within the conduit and distal to the site of implantation, further supporting that the conduit promoted nerve repair over this period of time. This study describes the design considerations and fabrication of a novel multicomponent, multimodal bio-engineered synthetic conduit for peripheral nerve repair. AbstractInjury to nerve tissue in the Peripheral Nervous System (PNS) results in long-term impairment of limb function, dysaesthesia and pain, often with associated psychological effects. Whilst minor injuries can be left to regenerate without intervention and short gaps up to 2 cm can be sutured, larger or more severe injuries commonly require autogenous nerve grafts harvested from elsewhere in the body (usually sensory nerves). Functional recovery is often suboptimal and associated with loss ...

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Biological and Synthetic Conduits in Peripheral Nerve Repair: A Comparative Experimental Study

Cited by 33 publications

References 9 publications

Functional assessment of sciatic nerve reconstruction: Biodegradable poly (DLLA-?-CL) nerve guides versus autologous nerve grafts

Functional assessment of sciatic nerve reconstruction: Biodegradable poly (DLLA-?-CL) nerve guides versus autologous nerve grafts

Long-term evaluation of functional nerve recovery after reconstruction with a thin-walled biodegradable poly (DL-Lactide-?-caprolactone) nerve guide, using walking track analysis and electrostimulation tests

Engineering a multimodal nerve conduit for repair of injured peripheral nerve

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