Peripheral Nerve War Injuries

Vrebalov-Cindro, Veselin; Reić, Petar; Ognjenović, Marina; Janković, Stipan; Anđelinović, Šimun; Karelovic, Deny; Kapural, Leonardo; Rakić, Mladen; Primorac, Dragan

doi:10.1093/milmed/164.5.351

Cited by 15 publications

(3 citation statements)

References 2 publications

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“…Studies of war victims (soldiers and civilians alike) have shown that peripheral nerve injuries account for approximately 70% to 80% of all trauma (11,12). In the past decade, the focus of neurobiological research has been to develop an ideal nerve growth factor that enhances axonal growth in terms of the rate of advancement and the density of nerve fibres.…”

Section: Discussionmentioning

confidence: 99%

Functional assessment of the sciatic nerve after repair with local delivery of FK 506 in rats

Nelluri¹

2002

J Plast Surg

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Difficulties with nerve repair are addressed principally in two ways -one is a meticulous apposition of nerve fibres by microsurgical techniques and the other is the facilitation of the regeneration of proximal axons by neurotrophic factors. The latter concept essentially involves optimizing the microenvironment at the site of injury by biochemical influences. FK 506 (tacrolimus), an immunosuppressive agent, has been recently found to have nerve regenerative potential in experimental animals; however, the various toxic effects of the drug, when used systemically (which has been the case in all of these experiments), limit its clinical use. To prevent such toxic effects of FK 506 in a nerve injury model, a local drug delivery method was developed by suspending a known concentration of FK 506 in fibrin glue (fibrin sealant) to release slowly 1 mg of the drug at the local site. MATERIALS AND METHODS:The sciatic nerve was transected in 18 rats and primary microsurgical repair was performed. Rats in group 1, the control group, had transection and primary repair, those in group 2 had transection and primary repair reinforced with fibrin sealant, and those in group 3 had primary repair that was reinforced with fibrin sealant and FK 506 (1 mg). A walking track analysis was performed, beginning in the second week, to evaluate functional recovery of the sciatic nerve. RESULTS: Overall, the animals that received FK 506 showed earlier recovery than those in the control group. Further, mean footprint length factors of the rats in group 3 showed significant early improvement between four and five weeks after surgery, whereas the improvements in groups 1 and 2 started toward normalization a week later, between five and six weeks after surgery. The experimental goal of the study was to determine whether locally delivered FK 506 is beneficial to nerve regeneration.

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Section: Discussionmentioning

confidence: 99%

Functional assessment of the sciatic nerve after repair with local delivery of FK 506 in rats

Nelluri¹

2002

J Plast Surg

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show abstract

“…Although the precise incidence of peripheral nerve injury is unknown, it is one of the most common traumatic upper extremity injuries. Studies of war victims (soldiers and civilians alike) have shown that peripheral nerve injuries account for approximately 70% to 80% of all trauma (11,12). In the past decade, the focus of neurobiological research has been to develop an ideal nerve growth factor that enhances axonal growth in terms of the rate of advancement and the density of nerve fibres.…”

Section: Discussionmentioning

confidence: 99%

Functional assessment of the sciatic nerve after repair with local delivery of FK 506 in rats

Nelluri¹,

Lyons²,

Nastala

et al. 2002

Canadian Journal of Plastic Surgery

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Difficulties with nerve repair are addressed principally in two ways – one is a meticulous apposition of nerve fibres by microsurgical techniques and the other is the facilitation of the regeneration of proximal axons by neurotrophic factors. The latter concept essentially involves optimizing the microenvironment at the site of injury by biochemical influences. FK 506 (tacrolimus), an immunosuppressive agent, has been recently found to have nerve regenerative potential in experimental animals; however, the various toxic effects of the drug, when used systemically (which has been the case in all of these experiments), limit its clinical use. To prevent such toxic effects of FK 506 in a nerve injury model, a local drug delivery method was developed by suspending a known concentration of FK 506 in fibrin glue (fibrin sealant) to release slowly 1 mg of the drug at the local site. Materials and Methods The sciatic nerve was transected in 18 rats and primary microsurgical repair was performed. Rats in group 1, the control group, had transection and primary repair, those in group 2 had transection and primary repair reinforced with fibrin sealant, and those in group 3 had primary repair that was reinforced with fibrin sealant and FK 506 (1 mg). A walking track analysis was performed, beginning in the second week, to evaluate functional recovery of the sciatic nerve. Results Overall, the animals that received FK 506 showed earlier recovery than those in the control group. Further, mean footprint length factors of the rats in group 3 showed significant early improvement between four and five weeks after surgery, whereas the improvements in groups 1 and 2 started toward normalization a week later, between five and six weeks after surgery. The experimental goal of the study was to determine whether locally delivered FK 506 is beneficial to nerve regeneration.

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“…A total of 713 patients (99% male) were reported with peripheral nerve injuries due to war in Croatia and Bosnia and Herzegovina. The majority had single‐nerve lesions with the peroneal (21%) and ulnar (20%) being the most common 36. In U.S. Army casualties of the Persian Gulf Conflict, the most common nerves affected in one report were median (18%), peroneal (16%), ulnar (12%), and radial (11%) 34 ; however, when considering 10‐year outcomes, there was no significant difference in the rate of peripheral neuropathy between deployed and nondeployed Gulf War veterans 37…”

Section: Armed Conflictmentioning

confidence: 99%

Neurological disorders in complex humanitarian emergencies and natural disasters

Mateen

2010

Annals of Neurology

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Complex humanitarian emergencies include the relatively acute, severe, and overwhelming health consequences of armed conflict, food scarcity, mass displacement, and political strife. Neurological manifestations of complex humanitarian emergencies are important and underappreciated consequences of emergencies in populations worldwide. This review critically assesses the existing knowledge of the range of neurological disorders that accompany complex humanitarian emergencies and natural disasters in both the acute phase of crisis and the "long shadow" that follows.

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Peripheral Nerve War Injuries

Cited by 15 publications

References 2 publications

Functional assessment of the sciatic nerve after repair with local delivery of FK 506 in rats

Functional assessment of the sciatic nerve after repair with local delivery of FK 506 in rats

Functional assessment of the sciatic nerve after repair with local delivery of FK 506 in rats

Neurological disorders in complex humanitarian emergencies and natural disasters

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