Peripheral Nerve Regeneration

Jain, Aditya; Valmikinathan, Chandra M.; Bellamkonda, Ravi V.

doi:10.1016/b978-0-08-055294-1.00183-5

Cited by 5 publications

(3 citation statements)

References 308 publications

(174 reference statements)

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“…Spontaneous reinnervation in most cases will occur naturally, driven by axonal directional growth (neurotropism), axon maturity (neurotrophy), axon guidance (contact guidance) and precise axon reinnervation (specificity) [14]. However, in a large gap (>2 cm) between the proximal and distal ends, these axonal inherent properties will be affected [23], along with tension, infection, foreign bodies or scar tissue formation (neuroma), thus warranting surgical intervention [71].…”

Section: Injurymentioning

confidence: 98%

“…This in turn will cause axonal degeneration, a process known as Wallerian degeneration (WDG) taking place initially (1-2 days following the trauma) at the distal end of the lesion [49]. WDG is compounded by the isolation from the structurally and functionally supportive cell body [23]. The permeability of the blood-nerve barrier increases during WDG and as a consequence, macrophages from the neighbouring blood vessels network will recruit and accumulate at the site of injury [59].…”

Section: Injurymentioning

confidence: 99%

“…When surgical repair is required for a severed nerve which can be coapted without tension, the best results are achieved with the direct end-to-end repair method [23,83]. This is commonly achieved with three monofilament nonabsorbable (8-0 to 10-0) sutures for an epineural repair (Fig.…”

Section: Direct Repairmentioning

confidence: 99%

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Nerve repair: toward a sutureless approach

et al. 2014

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Peripheral nerve repair for complete section injuries employ reconstructive techniques that invariably require sutures in their application. Sutures are unable to seal the nerve, thus incapable of preventing leakage of important intraneural fluids from the regenerating nerve. Furthermore, sutures are technically demanding to apply for direct repairs and often induce detrimental scarring that impedes healing and functional recovery. To overcome these limitations, biocompatible and biodegradable glues have been used to seal and repair peripheral nerves. Although creating a sufficient seal, they can lack flexibility and present infection risks or cytotoxicity. Other adhesive biomaterials have recently emerged into practice that are usually based on proteins such as albumin and collagen or polysaccharides like chitosan. These adhesives form their union to nerve tissue by either photothermal (tissue welding) or photochemical (tissue bonding) activation with laser light. These biomaterial adhesives offer significant advantages over sutures, such as their capacity to unite and seal the epineurium, ease of application, reduced invasiveness and add the potential for drug delivery in situ to facilitate regeneration. This paper reviews a number of different peripheral nerve repair (or reconstructive) techniques currently used clinically and in experimental procedures for nerve injuries with or without tissue deficit.

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Section: Injurymentioning

confidence: 98%