Clinical Study of Sensory Recovery of Artificial Nerve Grafts (Nerbridge®)

Abstract

Purpose: To examine postoperative sensory recovery of patients who used Nerbridge® for sensory nerves, and the indications. Subjects and methods: We investigated length of the transplanted nerve, postoperative sensory evaluation, and Disabilities of Arm, Shoulder and Hand (DASH) score in patients who underwent surgery at our center and could be followed up for at least 6 months. The participants were 11 patients (8 men and 3 women) with 17 nerves for study whose mean age at the time of injury was 48 years (15-64 years) and mean follow-up period was 14.4 months (6-28 months). We used the Semmes Weinstein (SW) test for postoperative sensory evaluation. Results: Mean length of the transplanted nerve was 17.3 mm (3-41 mm); the sensory evaluation had 8 patients in the blue range, 6 in the purple range, and 3 in the red range; and the mean DASH score was 16.3 points (1.7-37.5 points). The results tended to be unfavorable for patients with severe injuries such as an amputated finger and those with relatively long transplanted nerves. The results of this study indicated that Nerbridge® worked well with digital nerve deficits on the order of 20 mm. Discussion: When the results following artificial nerve transplants were as good as or better than nerve autografts, the donor site was not problematic and the transplantations with artificial nerves were clearly useful. The product would be decomposed and absorbed in vivo in approximately 3 months. Although the product can be used for a maximum length of 50 mm, in a deficit over 30 mm, the regenerating nerve might be metabolized before reaching its distal nerve stump; thus, a nerve autograft would be preferred in that situation.

Implantable Biomaterials for Peripheral Nerve Regeneration–Technology Trends and Translational Tribulations

“…The newest FDA approved product is Nerbridge, which is composed of polyglycolic acid and collagen derived from porcine skin. This product is composed of resorbable and semipermeable tubular membrane matrix filled with porous collagen and provides a non-constricting encasement for injured peripheral nerves ( Matsui et al, 2016 ). Despite many advantages of synthetic materials, their biologcial performance cannot reach allogenic nerve grafts.…”