Limitations of nerve repair of segmental defects using acellular conduits

Berrocal, Yerko; Almeida, Vania W.; Levi, Allan D.

doi:10.3171/2013.4.jns121938

Cited by 31 publications

(11 citation statements)

References 46 publications

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“…The follow-up rate in this study is unclear, however. Berrocal et al (2013) reported a single case of failed PNA repair of ulnar nerve at wrist level. Their patient underwent re-exploration and excision of the 'regenerated cable', which demonstrated minimal axonal regeneration at the midpoint of the repair.…”

Section: Failed Peripheral Nerve Reconstruction With Processed Nerve mentioning

confidence: 99%

Failed peripheral nerve reconstruction with processed nerve allografts in three patients

Nietosvaara

Grahn

Sommarhem

2018

J Hand Surg Eur Vol

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Section: Failed Peripheral Nerve Reconstruction With Processed Nerve mentioning

confidence: 99%

Failed peripheral nerve reconstruction with processed nerve allografts in three patients

Nietosvaara

Grahn

Sommarhem

2018

J Hand Surg Eur Vol

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“…Experimental studies demonstrated that tubular repair of short 3–5 mm nerve gap tubes yielded functional recovery at least as good as routine microsurgical repair in the short term [33,34]. In the long term, these grafts may become harmful by virtue of toxicity or tendency to constrict the nerve [35,36]. It should be pointed out that the relative efficacy between nerve grafts and hollow tube repair is difficult to evaluate because different model systems have been used and are not easily compared [37].…”

Section: Peripheral Nerve Repair By Nerve Grafting or Conduit Implmentioning

confidence: 99%

Natural Occurring Silks and Their Analogues as Materials for Nerve Conduits

Radtke

2016

IJMS

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Spider silk and its synthetic derivatives have a light weight in combination with good strength and elasticity. Their high cytocompatibility and low immunogenicity make them well suited for biomaterial products such as nerve conduits. Silk proteins slowly degrade enzymatically in vivo, thus allowing for an initial therapeutic effect such as in nerve scaffolding to facilitate endogenous repair processes, and then are removed. Silks are biopolymers naturally produced by many species of arthropods including spiders, caterpillars and mites. The silk fibers are secreted by the labial gland of the larvae of some orders of Holometabola (insects with pupa) or the spinnerets of spiders. The majority of studies using silks for biomedical applications use materials from silkworms or spiders, mostly of the genus Nephila clavipes. Silk is one of the most promising biomaterials with effects not only in nerve regeneration, but in a number of regenerative applications. The development of silks for human biomedical applications is of high scientific and clinical interest. Biomaterials in use for biomedical applications have to meet a number of requirements such as biocompatibility and elicitation of no more than a minor inflammatory response, biodegradability in a reasonable time and specific structural properties. Here we present the current status in the field of silk-based conduit development for nerve repair and discuss current advances with regard to potential clinical transfer of an implantable nerve conduit for enhancement of nerve regeneration.

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“…The allograft nerves are technically inset like autogenous cable nerve grafts. Recent data indicates that motor regeneration is superior to conduits but inferior to autogenous grafts [10,[12][13][14][15]. Only 1 in 12 conduits achieved meaningful recovery for mixed nerves with less than 25 mm defects [16].…”

Section: Direct Nerve Repair Vs Autogenous Cable Graftingmentioning

confidence: 99%

Management of Iatrogenic Ulnar Nerve Transection

Henry

2016

J Hand Microsurg

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A case of iatrogenic ulnar nerve laceration at the elbow is presented. Five subsequent surgeries over the course of the ensuing 20 months were performed to address this complication. The article examines the scientific basis for the various decisions needed to formulate a strategy that effectively addresses the problem. Emphasis is placed on the microsurgery of nerve topics: direct nerve repair, autogenous cable nerve grafting, biodegradable conduits, decellularized nerve allograft, and transfer of the anterior interosseous nerve to the ulnar motor branch. The discussion covers the relationship between choices made at the level of the original injury at the cubital tunnel to the timing and selection of distal reconstructive efforts, with specific attention to the distinction between end-to-end anterior interosseous to ulnar motor branch transfer as opposed to the supercharged end-to-side variation of this procedure.

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Limitations of nerve repair of segmental defects using acellular conduits

Abstract: Abbreviations used in this paper: AGC = axon guidance channel; PGA = polyglycolic acid; PNI = peripheral nerve injury.

Cited by 31 publications

References 46 publications

Failed peripheral nerve reconstruction with processed nerve allografts in three patients

Failed peripheral nerve reconstruction with processed nerve allografts in three patients

Natural Occurring Silks and Their Analogues as Materials for Nerve Conduits

Management of Iatrogenic Ulnar Nerve Transection

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