Comparison of the Performance of Chronically Versus Freshly Denervated Autograft in Nerve Repair

Isaacs, Jonathan; Adams, Scott C.; Mallu, Satya; Loveland, Kerry; Sandbulte, Zachary

doi:10.1016/j.jhsa.2010.07.037

Cited by 7 publications

(6 citation statements)

References 21 publications

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“…The more established the denervation atrophy (i.e., the longer the period of denervation), the smaller the muscle fiber; and the more widespread the denervation, the greater the percentage of small muscle fibers. Even with complete denervation, immediate repair results in only minimal final deficit, and other studies have demonstrated similar high levels of return as seen in our rodents subjected to this manipulation (group C). Prolonged complete denervation of 8 months, on the other hand, would be expected to result in all affected muscle fibers developing some level of permanent denervation atrophy limiting the final recovery size (group D) .…”

Section: Discussionsupporting

confidence: 86%

Does partial muscle reinnervation preserve future re‐innervation potential?

et al. 2017

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Introduction Late revision nerve surgery for incomplete motor recovery due to partial reinnervation would improve muscle function only if all muscle fibers were protected from developing denervation atrophy. Methods Sixty immature Sprague-Dawley rats underwent the following tibial nerve manipulations (n=15/group): Group A, partial denervation (2/3 of nerve resected and remaining 1/3 crushed), revision repair at 8 months; Group B, partial denervation; Group C, complete denervation, immediate reconstruction; Group D, complete denervation, reconstruction at 8 months; Group E, control group. Final testing at 11 months included muscle force, weight, and histology. Results Muscle weight was significantly (P < 0.05) different among all groups (highest to lowest: E>B>C>A>D), and force was significantly lower in A and D compared to E. Muscle fiber cross-sectional area was statistically smaller in A than in B, C, or E. Discussion Partial reinnervation still allowed substantial muscle recovery, but it did not preserve the noninnervated muscle fibers.

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Section: Discussionsupporting

confidence: 86%

Does partial muscle reinnervation preserve future re‐innervation potential?

et al. 2017

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“…For example, irreversibly damaged ulnar nerves after substantial trauma have been harvested as vascularized nerve grafts [20,21]. With associated injury to the lower trunk of the brachial plexus, the ulnar nerve has also been harvested to treat injuries to other parts of the brachial plexus [19]. The advantages to this strategy include the harvesting of an expendable nerve in the same surgical field and the avoidance of morbidity associated with a separate harvest site.…”

Section: Discussionmentioning

confidence: 99%

“…Isaacs et al previously compared fresh and chronically-denervated autograft in a rodent nerve repair model [19]. However, their harvest was from the distal stump of a previously transected peroneal nerve.…”

Section: Discussionmentioning

confidence: 99%

“…The proximal stump may confer a regenerative advantage over the distal stump because of greater preservation of trophic support. Previous studies have revealed chronically-denervated nerves distal to the zone of injury are inferior to fresh donor nerves for nerve grafting [19]. However, the utility of the nerve segment proximal to the zone of injury has not been explored in animal or clinical studies.…”

Section: Introductionmentioning

confidence: 99%

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A chronically-denervated versus a freshly-harvested autograft for nerve repair in rats

Pulley¹,

Luo²,

Barnwell³

et al. 2016

Hand Microsurg

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Objectives Autologous nerve grafting remains the gold standard for repair of peripheral nerve injuries. Its use, however, is limited by donor nerve availability and donor site morbidity. This is especially problematic after failure of an initial autograft that requires a repeat nerve graft, resulting in a second surgical site with associated morbidity. Based on the molecular differences in nerve degeneration in the proximal and distal segments after transection, we hypothesized that a chronically-denervated proximal stump may be viable for autologous nerve repair. Methods 20 Sprague-Dawley rats underwent right sciatic nerve excision and sural nerve transection. After 8 weeks, nerve repair was performed by harvesting the proximal segment of the sural nerve (n=10) or a fresh sural nerve (n=10) from the contralateral hind limb. Electrophysiological changes were analyzed to compare the fresh and denervated grafts. Results Electrophysiological testing demonstrated higher compound motor action potential in the denervated group compared to the fresh autograft group, however this difference was not statistically significant (p=0.117). Conclusion The proximal segment of a chronically-denervated sural nerve can be as effective as a fresh sural nerve for autologous repair of peripheral nerve injuries in a rodent model.

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“…49 Although any ''sacrificable'' nerve can be used, the sural nerve remains the work horse and generally is not missed. For defects longer than 5 cm or for major peripheral nerves such as the median nerve, autograft is still (typically) the first choice.…”

Section: Nerve Autograftmentioning

confidence: 99%

Different nerve grafting and wrapping options in upper extremity surgery

Isaacs

McMurtry

2014

Current Orthopaedic Practice

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Scar tissue can interfere with axonal regeneration and ultimate nerve function. Resection of scar tissue, however, results either in a nerve defect (if the scar tissue is intraneural) or the potential for recurrent extraneural scarring. Both biologic and off-the-shelf options exist for bridging short nerve gaps though understanding their limitations will improve the chances of successful application. Similarly, an appreciation of the available biologic and off-the-shelf nerve wrapping options can facilitate choosing the most appropriate adhesion barrier.

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Comparison of the Performance of Chronically Versus Freshly Denervated Autograft in Nerve Repair

Cited by 7 publications

References 21 publications

Does partial muscle reinnervation preserve future re‐innervation potential?

Does partial muscle reinnervation preserve future re‐innervation potential?

A chronically-denervated versus a freshly-harvested autograft for nerve repair in rats

Different nerve grafting and wrapping options in upper extremity surgery

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