Nerve repair and regeneration: Biological tubulization limits and future perspectives

Abstract

Peripheral nerve physiology and regeneration has been observed and investigated in literature but surgical applications to reconstruct and restore motor or sensory functions are still in a developmental phase. The peripheral nerve progresses slowly and incompletely compared with other tissues, it may provoke separations of the nerve stumps and the axonal proliferation of the conduits is restricted to 30 mm. Recent surgical attempts to treat proximal nerve injures include direct nerve restoration, transfer, and autografting measures with favorable results. Moreover, studies are suggesting that engineering tissue tubes maybe as effective as nerve grafting to restore separations of more than 4 cm toward optimal nerve repair.

Brain Derived Neurotrophic Factor and Glial Cell Line-Derived Neurotrophic Factor-Transfected Bone Mesenchymal Stem Cells for the Repair of Periphery Nerve Injury

“…Hence, the use of nerve guide conduits could avoid these problems ( Chrzaszcz et al, 2018 ; Chen et al, 2019 ; Vijayavenkataraman et al, 2019 ). However, the reported nerve conduits could not fully meet the demands for quick and effective nerve repair ( Carvalho et al, 2019 ; Riccio et al, 2019 ).…”

Reconstruction of a long defect of the median nerve with a free nerve conduit flap

“…A traumatic injury may be too extensive for end-to-end stump su- turing to be performed, although direct nerve suturing with minimal tension is required to promote satisfactory axon regeneration [6]. It is therefore clear that these circumstances require nerve grafts of various lengths, which are fundamental in the reconstructive surgery of peripheral nerves [2] to bridge the gap caused by traumatic injuries. The most accessible nerve to harvest is the sural nerve, which can be removed with minimal damage.…”

Collagen‐rich deposit formation in the sciatic nerve after injury and surgical repair: A study of collagen‐producing cells in a rabbit model

“…Researchers also report significant limitations of using the conduits. Crucial limitations include premature deterioration of conduit materials, creation of unwanted acidic environment, and tissue necrosis (Riccio, Marchesini, Pugliese, & De Francesco, 2019).…”