Evaluation of functional nerve recovery after reconstruction with a poly (DL-Lactide-ε-Caprolactone) nerve guide, filled with modified denatured muscle tissue

Meek, Marcel F.; Dunnen, Wilfred F.A. den; Schakenraad, Jm; Robinson, Frederick

doi:10.1002/(sici)1098-2752(1996)17:10<555::aid-micr5>3.0.co;2-p

Cited by 67 publications

(19 citation statements)

References 25 publications

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“…Experimentally, the addition of several additives inside a nerve guide is possible, which may enable the regenerative growth of peripheral nerve axons to continue over longer distances, and/or may accelerate the regenerative growth of the axons. 42,43 Of all clinical studies performed with resorbable nerve conduits so far, the first multicenter randomized study was described by Weber et al, utilizing a polyglycolic acid (PGA) nerve guide. 17 The control group consisted of direct repairs and the classic nerve graft.…”

Section: Solutionsmentioning

confidence: 99%

Poor results after nerve grafting in the upper extremity: Quo vadis?

Meek¹,

Coert²,

Robinson³

2005

Microsurgery

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The clinical success of peripheral nerve grafting in the upper extremity was evaluated retrospectively in 41 patients. This study comprises a 10-year follow-up in a single institution. Donor and acceptor site morbidity as well as functional nerve recovery were evaluated. Thirty-one men and 10 women were included. Autologous nerve grafts were used for reconstruction of digital nerves in 17 patients, ulnar nerves in 12 patients, median nerves in 10 patients, radial nerve in 1 patient, and both the radial and median nerve in 1 patient. The length of nerve grafts ranged from 1-12.5 cm (mean, 4.8 cm). The follow-up period ranged from 18 months to 10 years. Acceptor site-related problems were noted in 51%% (n = 21) of patients. Donor-site morbidity was seen in 4 patients (10%%). The return of function was scored as "good" in 3 (7%%), "fair" in 11 (27%%), and "bad" in 27 (66%%) patients. The outcome of autologous nerve grafts in this small group of patients treated by several surgeons was unfavorable in terms of function. Recent experimental and clinical studies with biodegradable nerve guides for the repair of peripheral nerve gaps showed superior results in comparison to classic nerve grafts.

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Section: Solutionsmentioning

confidence: 99%

Poor results after nerve grafting in the upper extremity: Quo vadis?

Meek¹,

Coert²,

Robinson³

2005

Microsurgery

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“…106 Another technique to prepare denatured skeletal muscle tissue, one based on alcohol treatment and aimed at an open extracellular matrix structure and an intact basement membrane, has demonstrated good prospects for repair of longer sciatic nerve gaps in the rat model. 107 Another step to prevent fragmentation and shrinkage was proposed by the use of intramuscular injections of local anesthetics to obtain basal lamina muscle autografts. [108][109] Mligiliche et al were the first to suggest the use of a detergent to denature skeletal muscle fibers to provide effective conduits for regenerating sciatic nerve axons in the rat and rabbit.…”

Section: Experimental Studiesmentioning

confidence: 99%

“…107,117,118 A study by Mligiliche et al has shown that this technique can make it possible to successfully bridge 5-cm-long nerve gaps in the rabbit sciatic nerve model. 119 Fresh skeletal muscle tissue can also be used in combination with synthetic biodegradable tubes, leading to successful repair of 1-cm-long defects of the rat sciatic nerve.…”

Section: Experimental Studiesmentioning

confidence: 99%

Use of Skeletal Muscle Tissue in Peripheral Nerve Repair: Review of the Literature

Meek¹,

Varejão

Geuna

2004

Tissue Engineering

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The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, necessitates a donor nerve and corresponding deficit. Many alternative techniques have thus been developed. The use of skeletal muscle tissue as graft material for nerve repair is one example. The rationale regarding the use of the skeletal muscle tissue technique is the availability of a longitudinally oriented basal lamina and extracellular matrix components that direct and enhance regenerating nerve fibers. These factors provide superiority over other bridging methods as vein grafts or (non)degradable nerve conduits. The main disadvantages of this technique are the risk that nerve fibers can grow out of the muscle tissue during nerve regeneration, and that a donor site is necessary to harvest the muscle tissue. Despite publications on nerve conduits as an alternative for peripheral nerve repair, autologous nerve grafting is still the standard care for treatment of a nerve gap in the clinical situation; however, the use of the skeletal muscle tissue technique can be added to the surgeon's arsenal of peripheral nerve repair tools, especially for bridging short nerve defects or when traditional nerve autografts cannot be employed. This technique has been investigated both experimentally and clinically and, in this article, an overview of the literature on skeletal muscle grafts for bridging peripheral nerve defects is presented.

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“…One promising approach is tubulization, which involves enclosure of the ends of a severed nerve by a tube that holds the stumps in place. The critical functions of a nerve conduit include providing mechanical support, confining intrinsic growth factors in situ , preventing neuroma formation and minimizing infiltration of fibrous tissue 3, 4. The use of synthetic nerve guidance tubes or nerve conduits has proven a success in bridging peripheral nerve gaps.…”

Section: Introductionmentioning

confidence: 99%

In vitro and in vivo testing of novel ultrathin PCL and PCL/PLA blend films as peripheral nerve conduit

Sun

Kingham

Reid

et al. 2009

J Biomedical Materials Res

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In an attempt to obviate the drawbacks of nerve autograft, ultrathin microporous biodegradable PCL and PCL/PLA films were tested for their compatibility with motor neuron-like NG108-15 cells and primary Schwann cells. Data obtained from MTS colorimetric and DNA fluorimetric assays showed that both cell lines readily attached and proliferated on these materials. Images taken using scanning electron microscope and fluorescence microscope confirmed these observations. Enhanced cell-surface interaction was achieved by pretreating the films in NaOH solution. Importantly, NG108-15 cells could be induced into differentiated phenotype with long, un-branched neurites growing across the surface of the materials. The bipolar spindle-shaped phenotype of Schwann cells was also retained on these scaffolds. Positive immunochemical staining using antibodies against neurofilament for NG108-15 cells and S100 for Schwann cells indicated the expression of these marker proteins. In a small-scaled pilot testing, the performance of PCL conduits in bridging up a 10 mm gap in rat sciatic nerve model was assessed. Immunohistochemical staining showed that regenerated nerve tissue and penetrated Schwann cells have the potential to span the whole length of the conduit in 2 weeks.

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Evaluation of functional nerve recovery after reconstruction with a poly (DL-Lactide-ε-Caprolactone) nerve guide, filled with modified denatured muscle tissue

Cited by 67 publications

References 25 publications

Poor results after nerve grafting in the upper extremity: Quo vadis?

Poor results after nerve grafting in the upper extremity: Quo vadis?

Use of Skeletal Muscle Tissue in Peripheral Nerve Repair: Review of the Literature

In vitro and in vivo testing of novel ultrathin PCL and PCL/PLA blend films as peripheral nerve conduit

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