Peripheral nerve regeneration through P(DLLA-ε-CL) nerve guides

Dunnen, den Wilfred; Meek, Marcel F.; Robinson, P. H.; Schakernraad, JM

doi:10.1023/a:1008987910224

Cited by 34 publications

(33 citation statements)

References 5 publications

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“…Currently, Neurolac ® [154][155][156] is the only FDA-approved caprolactone conduit ( Table 2). Several reports have been made in the application of PCL conduits in sciatic rat nerve repair [157][158][159][160][161][162]. Bertleff et al [154] performed a randomized prospective multicentre study where PCL conduits were comparable to either primary end-to-end repair or nerve autograft.…”

Section: Poly (D L Lactide-co-ε-caprolactone)mentioning

confidence: 99%

Scaffolds for Peripheral Nerve Regeneration, the Importance of In Vitro and In Vivo Studies for the Development of Cell-Based Therapies and Biomaterials: State of the Art

Pedrosa¹,

Caseiro²,

Santos³

et al. 2017

Scaffolds in Tissue Engineering - Materials, Technologies and Clinical Applications

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Human adult peripheral nerve injuries are a high incidence clinical problem that greatly affects patients' quality of life. Although peripheral nervous system has intrinsic regenerative capacity, this occurs in an incomplete or poorly functional manner. When a nerve fiber loses its continuity with consequent damage of the basal lamina tubes, axon spontaneous regeneration is disorganized and mismatched. These phenomena translate in an inadequate nerve functional recovery and consequent musculoskeletal incapacity. Nerve grafts still remain the gold standard in peripheral injuries treatment. However, this approach contains its disadvantages such as the necessity of primary surgery to harvest the autografts, loss of a functional nerve, donor site morbidity and longer surgery procedures. Therefore, biomaterials and tissue engineering can provide efficient resources and alternatives to nerve injury repair not only by the development of biocompatible structures but also, introducing neurotrophic factors and cellular systems to stimulate optimum clinical outcome. In this chapter, a comprehensive state-of-the art picture of tissue-engineered nerve grafts scaffolds, their application in nerve regeneration along with latest advances in peripheral nerve repair and future perspectives will be discussed, including our own large experience in this field of knowledge.

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Section: Poly (D L Lactide-co-ε-caprolactone)mentioning

confidence: 99%

Scaffolds for Peripheral Nerve Regeneration, the Importance of In Vitro and In Vivo Studies for the Development of Cell-Based Therapies and Biomaterials: State of the Art

Pedrosa¹,

Caseiro²,

Santos³

et al. 2017

Scaffolds in Tissue Engineering - Materials, Technologies and Clinical Applications

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“…Biodegradable conduits avoid the necessity of a second surgical operation and allow the delivery of incorporated Schwann cells or bioactive molecules during biodegradation (Ciardelli and Chiono 2006). Examples of bioresorbable polymers for nerve repair include aliphatic polyesters and copolyesters, such as poly(L-lactic acid) (PLLA) (Luciano et al 2000;Yang et al 2004), polyglycolic acid (PGA) (Nakamura et al 2004), poly(lactic acid-ε-caprolactone) (Den Dunnen et al 1998, poly(L-lactide-co-glycolide) (PLGA) (Bini et al 2004), poly(1,3-trimethylenecarbonate-ε-caprolactone) (Pego et al 2001) and poly(caprolactone) (PCL) (Bender et al 2004;Verreck et al 2005).…”

Section: Introductionmentioning

confidence: 99%

Melt-extruded guides for peripheral nerve regeneration. Part I: Poly(ε-caprolactone)

Chiono

Vozzi

et al. 2009

Biomed Microdevices

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Melt-extruded guides for peripheral nerve repair based on poly(epsilon-caprolactone) (PCL) were realised and their physico-chemical properties were evaluated. Preliminarily, PCL cast films were found to support the attachment and proliferation of Neonatal Olfactory Bulb Ensheating Cells (NOBEC). S5Y5 neuroblastoma cells were cultured inside PCL guides in their uncoated form or coated with a non-specific adhesion protein (gelatin) and a specific peptide for nerve regeneration (poly(L-lysine)). Coating increased cell density (gelatin) and/or the cell density rate on substrates (poly(L-lysine); gelatin) as compared to uncoated guides. Various in vivo tests were carried out for the repair of small (0.5 cm), medium (1.5 cm) and long (4.5 cm) size defects in the peripheral nerves of Wistar rats. For the small nerve defects, uncoated and coated PCL guides were tested. Results from in vivo tests were subjected to histological examination after 45 days, 6 and 8 months postoperative for small, medium and large defects, respectively. Regeneration was found for small and medium size defects. For 0.5 cm defects, the coating did not affect regeneration significantly. Grip-tests also evidenced functional recovery for the 1.5 cm-long defects treated with PCL guides, after 6 months from implantation. On the other hand, mechanical stiffness of PCL conduits impaired the repair of 4.5 cm-long defects in 8-month period: the lack of flexibility of the guide to rat movements caused its detachment from the implant site. The research showed that PCL guides can be used for the successful repair of small and medium size nerve defects, with possible improvements by suitable bio-mimetic coatings.

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“…[3][4][5]12 For several years many articles about the topic have been published and the value of the guide as a replacement for an autologous nerve graft has been established. 4,7,8,13 Weber et al 14 published their results after using a polyglycolic acid nerve guide in small defects (Ͻ4 mm) compared with end-to-end suturing. Despite this, using the nerve guide still is not common practice.…”

Section: Discussionmentioning

confidence: 99%

“…After 1 year it is degraded completely. 8 After many years of experimental research with the Neurolac tube a clinical trial was started. 8 -10 The purpose of this study was to evaluate the experience with the Neurolac nerve guide to treat sensory nerve defects in the human hand, distally from the wrist, in terms of adverse events and sensory nerve recovery.…”

mentioning

confidence: 99%

A Prospective Clinical Evaluation of Biodegradable Neurolac Nerve Guides for Sensory Nerve Repair in the Hand

Bertleff¹,

Meek²,

Nicolai³

2005

The Journal of Hand Surgery

202

103

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Peripheral nerve regeneration through P(DLLA-ε-CL) nerve guides

Cited by 34 publications

References 5 publications

Scaffolds for Peripheral Nerve Regeneration, the Importance of In Vitro and In Vivo Studies for the Development of Cell-Based Therapies and Biomaterials: State of the Art

Scaffolds for Peripheral Nerve Regeneration, the Importance of In Vitro and In Vivo Studies for the Development of Cell-Based Therapies and Biomaterials: State of the Art

Melt-extruded guides for peripheral nerve regeneration. Part I: Poly(ε-caprolactone)

A Prospective Clinical Evaluation of Biodegradable Neurolac Nerve Guides for Sensory Nerve Repair in the Hand

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