Nerve wrapping for recurrent compression neuropathy: A systematic review

Thakker, Arjuna; Sharma, Sanjeev; Hussain, Niha Mariam; Devani, Pooja; Lahiri, A.

doi:10.1016/j.bjps.2020.10.085

Cited by 8 publications

(10 citation statements)

References 24 publications

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“… 6 The vein’s biological compatibility facilitates a smooth gliding surface while simultaneously decreasing fibrotic adhesion formation between the venous intima and epineurium. 1 However, autograft wrap usage is limited by donor site complications and the longer operative time compared with allograft or xenograft wraps. Conversely, a concern with allograft and xenograft nerve wraps is immune tolerance in the host.…”

Section: Discussionmentioning

confidence: 99%

“…Wraps made up of mixtures are derived from porcine small intestine submucosa, whereas those made up of solely type I collagen are derived from bovine tendon. 1 Xenograft wraps provide the advantage of no donor site morbidity, but concerns arise from the potential to generate a host immune response or transmit disease. Still, no studies investigating xenograft processing techniques and outcomes for recurrent compression neuropathy found any evidence of rejection or complications.…”

Section: Discussionmentioning

confidence: 99%

“…The membrane represents a novel option for nerve wrapping, and animal studies have demonstrated reduced perineural fibrosis and adhesion formation as compared with those in controls. 1 However, most allograft nerve wraps are non-FDA-indicated, and unfavorable results have been seen when amniotic wraps were placed around flexor tendons, which result in inflammatory responses and local fibrosis. 8 This raised caution for use of allografts as nerve wraps, but the two studies investigating their use reported subjective and objective improvement without the need for subsequent revision procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, 1%–31% of patients report persistent or recurrent carpal or ulnar tunnel syndrome due to perineural fibrosis. 1 Various treatment options exist for recurrent compression neuropathies, including repeat decompression, neurolysis and tenosynovectomy, hypothenar fat pad flaps, and nerve wraps. Revision procedures continue to be a difficult prospect because access to the nerve is complicated by dense fibrous scar tissue.…”

mentioning

confidence: 99%

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Necrotic Granulomatous Inflammation after Use of Small Intestine Submucosa Matrix for Recurrent Compression Neuropathy

Koenig

Burns

Hayes

2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Various techniques exist for treating recurrent carpal and ulnar tunnel syndrome, but AxoGuard nerve wrap has shown promising results for treatment of compression neuropathies when used in conjunction with neurolysis and tenosynovectomy. Prior results demonstrate no safety concerns, and there have not been any reported cases of infection, persistent inflammation, or recurrent perineural fibrosis. A 41-year-old, right-hand-dominant woman experienced repeated bouts of carpal and ulnar tunnel syndromes, which were treated with a small intestine submucosa matrix wrap around the median and ulnar nerves in the wrist. Here, we report a case of necrotic granulomatous inflammation 2.5 months after AxoGuard xenograft nerve wrap was placed around the median and ulnar nerves. As a salvage, NuShield placental allograft was wrapped around the median nerve, which has shown promising results at several months follow-up. Placental allograft nerve wraps represent a useful tool in compression neuropathy resistant to autografts, xenografts, and revision decompression operations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Necrotic Granulomatous Inflammation after Use of Small Intestine Submucosa Matrix for Recurrent Compression Neuropathy

Koenig

Burns

Hayes

2022

Plastic and Reconstructive Surgery - Global Open

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“…In a recent review, improvement in subjective and objective outcomes were drawn across all studies using vein autografts and despite a paucity of clinical and experimental data, many surgeons tend to use nerve wraps to protect the repair. 68…”

Section: Primary Nerve Coaptationmentioning

confidence: 99%

Peripheral Nerve Healing: So Near and Yet So Far

et al. 2021

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Peripheral nerve injuries represent a considerable portion of chronic disability that especially affects the younger population. Prerequisites of proper peripheral nerve injury treatment include in-depth knowledge of the anatomy, pathophysiology, and options in surgical reconstruction. Our greater appreciation of nerve healing mechanisms and the development of different microsurgical techniques have significantly refined the outcomes in treatment for the past four decades. This work reviews the peripheral nerve regeneration process after an injury, provides an overview of various coaptation methods, and compares other available treatments such as autologous nerve graft, acellular nerve allograft, and synthetic nerve conduits. Furthermore, the formation of neuromas as well as their latest treatment options are discussed.

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