Effect of Amniotic Membrane Nerve Wrapping in Final Results of Traumatic Peripheral Nerve Repair

Abstract

BACKGROUNDPreventing perineural adhesions and scars formation in the traumatic peripheral injuries is very important on the recovery process. We aimed to evaluate the effect of using the amniotic membrane wrapping on the results of surgical treatment of damaged peripheral nerves. METHODSThis cohort study included 30 patients with symptoms of acute peripheral nerve injuries due to penetrating trauma in the forearm or wrist in January 2019 to November 2020 referred to the Hand and Microsurgery Department,

Repair methods in peripheral nerves after traumatic injuries: a systematic literature review

“…Another very obvious specialty is plastic surgery, possibly due to its restorative and aesthetic role, capable of improving the appearance of these injuries and restoring patients’ self-esteem 6 , 11 , 20 , 23 , 41 . From another perspective, primary articles were found involving surgeries in the field of orthopedics, as it is an area that usually deals with patients who have suffered traumatic injuries, using a range of technologies in their procedures, such as the prostheses 7 , 8 , 12 , 17 , 19 , 22 , 26 , 32 – 35 , 38 , 39 , 42 .…”

“…The suture of a peripheral nerve aims exclusively to bring the endoneurium conduits closer together to facilitate the passage of fibers in regeneration through the injury in which there has been a solution to the continuity of the connective framework. It is the best way to repair an injury of a peripheral nerve 46 and was identified in five studies in this review 7 , 8 , 34 , 37 , 39 .…”

“…In the universe of application of this method, in terms of regeneration, the group that underwent the intervention achieved nerve regeneration and functional recovery of the nerve in a period of 12 months, while the control group did not experience nerve recovery and had functional and sensory impairment. It should be noted that this technique is one of the simplest ways of preventing neuroma at the site of injury and seems to prevent adhesions and perineural scarring 8 .…”

Repair methods in peripheral nerves after traumatic injuries: a systematic literature review

“…Another very obvious specialty is plastic surgery, possibly due to its restorative and aesthetic role, capable of improving the appearance of these injuries and restoring patients’ self-esteem 6 , 11 , 20 , 23 , 41 . From another perspective, primary articles were found involving surgeries in the field of orthopedics, as it is an area that usually deals with patients who have suffered traumatic injuries, using a range of technologies in their procedures, such as the prostheses 7 , 8 , 12 , 17 , 19 , 22 , 26 , 32 – 35 , 38 , 39 , 42 .…”

“…The suture of a peripheral nerve aims exclusively to bring the endoneurium conduits closer together to facilitate the passage of fibers in regeneration through the injury in which there has been a solution to the continuity of the connective framework. It is the best way to repair an injury of a peripheral nerve 46 and was identified in five studies in this review 7 , 8 , 34 , 37 , 39 .…”

“…In the universe of application of this method, in terms of regeneration, the group that underwent the intervention achieved nerve regeneration and functional recovery of the nerve in a period of 12 months, while the control group did not experience nerve recovery and had functional and sensory impairment. It should be noted that this technique is one of the simplest ways of preventing neuroma at the site of injury and seems to prevent adhesions and perineural scarring 8 .…”

Extracellular Matrix and Amniotic Derivatives in Bone and Nerve Repair: A Narrative Review of Mechanisms and Their Preclinical and Clinical Applications

“…The AM can be wrapped around sutured nerves as a biological membrane to prevent scarring and provide trophic support. Animal studies and early human trials have suggested that AM wrapping around a repaired nerve limits perineural adhesions and neuroma formation, creating a favorable environment for regeneration [ 49 , 50 ]. The AM's avascular stromal matrix contains anti-inflammatory cytokines and neurotrophic factors that modulate the injury site by reducing fibrosis, inhibiting pro-inflammatory cytokine release, and supporting neural cell differentiation [ 49 , 50 ].…”

“…Animal studies and early human trials have suggested that AM wrapping around a repaired nerve limits perineural adhesions and neuroma formation, creating a favorable environment for regeneration [ 49 , 50 ]. The AM's avascular stromal matrix contains anti-inflammatory cytokines and neurotrophic factors that modulate the injury site by reducing fibrosis, inhibiting pro-inflammatory cytokine release, and supporting neural cell differentiation [ 49 , 50 ]. In a rodent model of nerve transection, AM wrapping coincided with faster functional recovery, supported by improved motor function and nerve conduction.…”

Repair methods in peripheral nerves after traumatic injuries: a systematic literature review

“…Another very obvious specialty is plastic surgery, possibly due to its restorative and aesthetic role, capable of improving the appearance of these injuries and restoring patients’ self-esteem 6 , 11 , 20 , 23 , 41 . From another perspective, primary articles were found involving surgeries in the field of orthopedics, as it is an area that usually deals with patients who have suffered traumatic injuries, using a range of technologies in their procedures, such as the prostheses 7 , 8 , 12 , 17 , 19 , 22 , 26 , 32 – 35 , 38 , 39 , 42 .…”

“…The suture of a peripheral nerve aims exclusively to bring the endoneurium conduits closer together to facilitate the passage of fibers in regeneration through the injury in which there has been a solution to the continuity of the connective framework. It is the best way to repair an injury of a peripheral nerve 46 and was identified in five studies in this review 7 , 8 , 34 , 37 , 39 .…”

“…In the universe of application of this method, in terms of regeneration, the group that underwent the intervention achieved nerve regeneration and functional recovery of the nerve in a period of 12 months, while the control group did not experience nerve recovery and had functional and sensory impairment. It should be noted that this technique is one of the simplest ways of preventing neuroma at the site of injury and seems to prevent adhesions and perineural scarring 8 .…”

Extracellular Matrix and Amniotic Derivatives in Bone and Nerve Repair: A Narrative Review of Mechanisms and Their Preclinical and Clinical Applications

“…The AM can be wrapped around sutured nerves as a biological membrane to prevent scarring and provide trophic support. Animal studies and early human trials have suggested that AM wrapping around a repaired nerve limits perineural adhesions and neuroma formation, creating a favorable environment for regeneration [ 49 , 50 ]. The AM's avascular stromal matrix contains anti-inflammatory cytokines and neurotrophic factors that modulate the injury site by reducing fibrosis, inhibiting pro-inflammatory cytokine release, and supporting neural cell differentiation [ 49 , 50 ].…”

“…Animal studies and early human trials have suggested that AM wrapping around a repaired nerve limits perineural adhesions and neuroma formation, creating a favorable environment for regeneration [ 49 , 50 ]. The AM's avascular stromal matrix contains anti-inflammatory cytokines and neurotrophic factors that modulate the injury site by reducing fibrosis, inhibiting pro-inflammatory cytokine release, and supporting neural cell differentiation [ 49 , 50 ]. In a rodent model of nerve transection, AM wrapping coincided with faster functional recovery, supported by improved motor function and nerve conduction.…”

Repair methods in peripheral nerves after traumatic injuries: a systematic literature review

“…Another very obvious specialty is plastic surgery, possibly due to its restorative and aesthetic role, capable of improving the appearance of these injuries and restoring patients’ self-esteem 6 , 11 , 20 , 23 , 41 . From another perspective, primary articles were found involving surgeries in the field of orthopedics, as it is an area that usually deals with patients who have suffered traumatic injuries, using a range of technologies in their procedures, such as the prostheses 7 , 8 , 12 , 17 , 19 , 22 , 26 , 32 – 35 , 38 , 39 , 42 .…”

“…The suture of a peripheral nerve aims exclusively to bring the endoneurium conduits closer together to facilitate the passage of fibers in regeneration through the injury in which there has been a solution to the continuity of the connective framework. It is the best way to repair an injury of a peripheral nerve 46 and was identified in five studies in this review 7 , 8 , 34 , 37 , 39 .…”

“…In the universe of application of this method, in terms of regeneration, the group that underwent the intervention achieved nerve regeneration and functional recovery of the nerve in a period of 12 months, while the control group did not experience nerve recovery and had functional and sensory impairment. It should be noted that this technique is one of the simplest ways of preventing neuroma at the site of injury and seems to prevent adhesions and perineural scarring 8 .…”

Extracellular Matrix and Amniotic Derivatives in Bone and Nerve Repair: A Narrative Review of Mechanisms and Their Preclinical and Clinical Applications

“…The AM can be wrapped around sutured nerves as a biological membrane to prevent scarring and provide trophic support. Animal studies and early human trials have suggested that AM wrapping around a repaired nerve limits perineural adhesions and neuroma formation, creating a favorable environment for regeneration [ 49 , 50 ]. The AM's avascular stromal matrix contains anti-inflammatory cytokines and neurotrophic factors that modulate the injury site by reducing fibrosis, inhibiting pro-inflammatory cytokine release, and supporting neural cell differentiation [ 49 , 50 ].…”

“…Animal studies and early human trials have suggested that AM wrapping around a repaired nerve limits perineural adhesions and neuroma formation, creating a favorable environment for regeneration [ 49 , 50 ]. The AM's avascular stromal matrix contains anti-inflammatory cytokines and neurotrophic factors that modulate the injury site by reducing fibrosis, inhibiting pro-inflammatory cytokine release, and supporting neural cell differentiation [ 49 , 50 ]. In a rodent model of nerve transection, AM wrapping coincided with faster functional recovery, supported by improved motor function and nerve conduction.…”