(iii) Peripheral nerve repair

Ryu, Jaiyoung; Beimesch, Claire F.; Lalli, Trapper J.

doi:10.1016/j.mporth.2011.03.003

Cited by 3 publications

(7 citation statements)

References 57 publications

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Section: Peripheral Nerve Anatomymentioning

confidence: 99%

“…The external layer is the epineurium, which consists of two components. Interfascicular epineurium surrounds each nerve fascicle, and the extrafascicular epineurium invests the entire nerve trunk and clinches the blood vessels to the nerve [4]. The epineurium is a quite strong layer and resists to compression injuries with its collagen fibres and lipid globules.…”

Section: Peripheral Nerve Anatomymentioning

confidence: 99%

“…Nerve exploration and repair indications are paralysis around the injured nerve, closed injury with supportive tissue damage, open injury requiring open reduction and internal fixation, nerve lesions with arterial damage, traction injuries to the brachial plexus, declining nerve function after diagnosis, failure of neurological improvement, failure to improve after a conduction block within 6 weeks of the injury and persistent pain or neuroma formation [4].…”

Section: Treatment Strategies Of Peripheral Nerve Injurymentioning

confidence: 99%

“…Owing to this structure, action potential jumps from one node to the next along the length of the axon and saltatory conduction occurs. This process results in faster conduction of the action potential in myelinated nerves rather than unmyelinated nerves [3,4].Connective support of the neuron consists of three laminary structures including endoneurium, perineurium, epineurium and mesoneurium. The deepest structural layer nearest to the axon is endoneurium, which is composed of collagen fibres.…”

mentioning

confidence: 99%

“…Surgical repair is required for recovery. The fifth-degree injury defines complete transaction of the nerve, and as in neurotmesis, surgical repair is necessary [4]. …”

mentioning

confidence: 99%

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Peripheral Nerve Injury and Current Treatment Strategies

Tezcan¹

2017

Peripheral Nerve Regeneration - From Surgery to New Therapeutic Approaches Including Biomaterials and Cell-Based Therapies Deve

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Neuronal cells are the main fundamental anatomic unit of the system. Nerve injuries are generally divided into three categories as neuropraxia, axonotmesis and neurotmesis. Neurotmesis is the most severe form. Schwann cells are activated within 24 hours of the injury and the healing cascade continued with the cells, which are stimulated by Schwann cells. And neurotrophic factors like nerve growth factor (NGF) have a crucial role in regeneration and degeneration processes. Additionally, Schwann cells upregulate the expression of some proteins, such as fibronectin, which are crucial for axonal regeneration. All this information about nerve healing sheds light on treatment studies. Iatrogenic nerve injury has an important place in peripheral nerve injury. Causes may be direct surgical damage, wrong intraoperative patient positioning, anaesthesiarelated reasons or limb tourniquets. Typical symptoms are motor or sensory deficits such as paraesthesia, weakness, paralysis and pain. Many of the traumatic nerve injuries require surgical repair. Direct nerve repair and autologous nerve grafts are still goldstandard treatment options. Additionally, nerve conduits are very successful to provide an ideal peripheral support for neuronal recovery but are still insufficient. In recent years, research efforts have focused on the neurotrophic factors and cell-based therapies to perform better microenvironment for neuronal healing.Keywords: peripheral nerve, injury, iatrogenic, nerve grafts, conduit, cell-based therapy IntroductionAn injury to a nerve can result in a problem with the muscle innervation or in a loss of sensation. In some people, it can also cause pain. The type of nerve injury will determine the type of treatment that will be needed. Peripheral nerve injuries (PNIs) affect all age groups and have many causes like trauma and medical disorders. The majority of the peripheral nerve injuries © 2017 The Author(s). Licensee InTech. This chapter is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.(PNI) occur in the upper extremity and are secondary to trauma [1]. Typical symptoms are motor or sensory deficits such as paraesthesia, weakness, paralysis and pain [2]. Many of the traumatic nerve injuries require surgical repair. The primary goal of the repair is to achieve the reinnervation of the target organs, but the therapeutic options which are used at present cannot achieve perfect sensory and motor recovery in all cases. In this chapter, the pathophysiology and mechanisms of nerve injuries, the traumatic nerve injuries, especially the iatrogenic forms, and therapeutic options for the peripheral nerve injuries will be discussed. Peripheral nerve anatomyPeripheral nervous system consists of neuronal cells, glial cells and stromal cells. Neuronal cells are the main fundamental anatomic unit of the system. Neurons conduct elec...

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Section: Peripheral Nerve Anatomymentioning

confidence: 99%

Section: Peripheral Nerve Anatomymentioning

confidence: 99%

Section: Treatment Strategies Of Peripheral Nerve Injurymentioning

confidence: 99%

mentioning

confidence: 99%

“…Surgical repair is required for recovery. The fifth-degree injury defines complete transaction of the nerve, and as in neurotmesis, surgical repair is necessary [4]. …”

mentioning

confidence: 99%

See 3 more Smart Citations

Peripheral Nerve Injury and Current Treatment Strategies

Tezcan¹

2017

Peripheral Nerve Regeneration - From Surgery to New Therapeutic Approaches Including Biomaterials and Cell-Based Therapies Deve

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Advances in stem cell treatment for sciatic nerve injury

Sayad-Fathi

Nasiri

Zaminy

2019

Expert Opinion on Biological Therapy

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Time-Dependent Proregenerative Effects of Exogenous Melatonin on the Transected Sciatic Nerve

et al. 2023

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Microsurgical procedures are the treatment of choice of peripheral nerve injuries, but often fail to reach full functional recovery. Melatonin has neuroprotective actions and might be used as a possible proregenerative pharmacological support. Therefore, the aim of this study was to analyze the time-dependence of the neuroprotective effect of melatonin on the overall fascicular structures of both ends of the transected nerve. Sciatic nerve transection was performed in 34 adult male Wistar rats divided in four groups: two vehicle groups (N=7) treated intraperitoneally for 7 (V7) or 21 (V21) consecutive days with vehicle (5 % ethanol in Ringer solution) and two melatonin groups (N=10) administered intraperitoneally 30 mg/kg of melatonin for 7 (M7) or 21 (M21) consecutive days. At the end of the experiment, proximal stump neuroma and distal stump fibroma were excised and processed for qualitative and quantitative histological analysis. Intrafascicular neural structures were better preserved and the collagen deposition was reduced in the melatonin treated groups than in the vehicle groups. Myelin sheath regeneration observed through its thickness measurement was statistically significantly (p<0,05) more pronounced in the M21 (1,23±0,18 µm) vs. V21 group (0,98±0,13 µm). The mean volume density of the endoneurium was lower in both melatonin treated groups in comparison to the matching vehicle treated groups. Although not statistically different, the endoneural tube diameter was larger in both melatonin groups vs. vehicle groups, and the effect of melatonin was more pronounced after 21 days (24,97 % increase) vs. 7 days of melatonin treatment (18,8 % increase). Melatonin exerts a time-dependent proregenerative effect on nerve fibers in the proximal stump and an anti-scarring effect in both stumps.

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(iii) Peripheral nerve repair

Cited by 3 publications

References 57 publications

Peripheral Nerve Injury and Current Treatment Strategies

Peripheral Nerve Injury and Current Treatment Strategies

Advances in stem cell treatment for sciatic nerve injury

Time-Dependent Proregenerative Effects of Exogenous Melatonin on the Transected Sciatic Nerve

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