Recurrent cubital tunnel syndrome treated with revision neurolysis and amniotic membrane nerve wrapping

Gaspar, Michael P.; Abdelfattah, Hesham; Welch, Ian W.; Vosbikian, Michael M.; Kane, Patrick M.; Rekant, Mark S.

doi:10.1016/j.jse.2016.09.013

Cited by 42 publications

(38 citation statements)

References 40 publications

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“…In a previous study, we found that an electrospun PCL-amnion nanofibrous membrane effectively prevented post-surgical tendon adhesion and promoted tendon healing [25]. Although there is a number of studies that report on the application of amniotic membranes in nerve repair, they are not yet widely used in the clinic [24,35]. Therefore, we investigated the effects of PCL-amnion on the repair of sciatic nerve compression.…”

Section: Plos Onementioning

confidence: 97%

Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane prevents adhesions and promotes nerve repair in a rat model of sciatic nerve compression

et al. 2020

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Adhesion and scarring after neural surgery are detrimental to nerve regeneration and functional recovery. Amniotic membranes have been used in tissue repair due to their immunogenicity and richness in cytokines. In this study, an electrospun polycaprolactone (PCL)-amnion nanofibrous membrane was prepared for the treatment of sciatic nerve compression in a rat model. The effects of the PCL-amnion nanofibrous membrane on the prevention of adhesion formation and nerve regeneration were evaluated using electrophysiology and histological analyses. Compared with the medical chitosan hydrogel dressing, the PCL-amnion nanofibrous membrane significantly reduced peripheral nerve adhesion and promoted the rapid recovery of nerve conduction. Moreover, the immunohistochemical analysis identified more Schwann cells and less pro-inflammatory M1 macrophages in the PCL-amnion group. Western blot and RT-PCR results showed that the expression levels of type-Ⅰ and Ⅲ collagen in the PCL-treated rats were half of those in the control group after 12 weeks, while the expression level of nerve growth factor was approximately 3.5 times that found in the rats treated with medical chitosan hydrogel. In summary, electrospun PCL-amnion nanofibrous membranes can effectively reduce adhesion after neural surgery and promote nerve repair and regeneration. The long-term retention in vivo and sustained release of cytokines make PCL-amnion a promising biomaterial for clinical application.

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Section: Plos Onementioning

confidence: 97%

Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane prevents adhesions and promotes nerve repair in a rat model of sciatic nerve compression

et al. 2020

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“…Gaspar, et al reported the use of a commercially-available amniotic membrane wrap (XWrap Dry; Applied Biologics, Scottsdale, AZ) during 8 revision cubital tunnel cases. 19 There were no signs of adverse reactions or complications reported, and all patients had clinical improvement in patient-reported outcomes and grip strength. However, preliminary results using amniotic wraps placed around repaired flexor tendons demonstrated unfavorable results with inflammatory responses and local fibrosis.…”

Section: Types Of Barriers Availablementioning

confidence: 78%

Barriers to Epineural Scarring: Role in Treatment of Traumatic Nerve Injury and Chronic Compressive Neuropathy

Aunins

Brogan

2018

The Journal of Hand Surgery

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The physiological limitations of neural regeneration make peripheral nerve surgery challenging to both the surgeon and the patient. Presence of nerve gaps and local wound factors may all influence outcome, suggesting that barriers to reduce perineural scarring, minimize fibrosis, and avoid ischemia would be beneficial. To examine the evidence supporting their use, we reviewed the autologous and commercially-available options for barriers against scarring around a nerve. Numerous clinical case series demonstrated the effectiveness and safety of local/rotational flaps and autologous vein wrapping when used in the presence of recurrent compressive neuropathy. Translational research in animal models supports the biocompatibility of commercially available nerve wraps following nerve repair. To date, there are no reports of clinical use of commercially available nerve wraps in acute nerve repair, but a growing number of case series demonstrate their effectiveness and safety in chronic compressive neuropathy. Limited clinical evidence exists to support the efficacy of vein or flap coverage in acute nerve repairs.

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“…Later, synthetic materials were developed for wrapping injured nerves ( Supplemental Table 1 ). 30 – 32 These aimed to address disadvantages of biologic wraps and isolate neurotrophic/neurotropic factors to the site of injury. 50 While synthetic options offer some structural advantages, they are often limited by issues related to their resorption.…”

Section: Discussionmentioning

confidence: 99%

“…More recently, wraps containing absorbable, acellular collagen matrices (ACM) have been used in cases of axonotmesis ( Supplemental Table 1 ). 30 – 32 , 51 These wraps have been derived from both human and animal tissue, and commercially available products include human amniotic membrane, porcine intestinal submucosa, and collagen type I. 51 These ACM wraps stimulate neovascularization and proliferation of axons with growth factors and cytokines.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

et al. 2021

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Background: Treatment of patients with traumatic axonotmesis presents challenges. Processed human umbilical cord membrane has been recently developed with improved handling and resorption time compared to other amniotic membrane wraps, and may be beneficial in nerve reconstruction. This study evaluates postoperative outcomes after traumatic peripheral nerve injury after placement of commercially available processed human umbilical cord membrane. Methods: We performed a prospective, single-center pilot study of patients undergoing multi-level surgical reconstruction for exposed, non-transected peripheral nerve. Functional outcomes including pain, range of motion, pinch and grip strength, and the QuickDASH and SF-36 patient-reported outcome measures were recorded, when possible, at the 1-week and 3, 6, and 9 months postop visit. One-tailed paired t-tests were performed to evaluate outcome improvement at final follow-up. Results: Twenty patients had processed human umbilical cord membrane placement without surgical complications. Mean follow-up was 7.5 months (range: 3–10 months) and mean age was 39 years (range: 15–65). Twelve (67%) patients were male, and the majority of placement sites were in the upper extremity (85%). Mean preoperative visual analog scale pain score was significantly reduced at most recent follow-up, as were QuickDASH scores. All patients had improved functional outcomes at the 9-month follow-up, and SF-36 outcomes at 9 months showed improvement across all dimensions. Conclusion: This study indicates that processed human umbilical cord membrane may be a useful adjunct in nerve surgery with noted improvements in postoperative function, pain, and patient-reported outcome measures. Future studies are needed to assess long-term outcomes after traumatic nerve injury treated with processed human umbilical cord membrane.

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Recurrent cubital tunnel syndrome treated with revision neurolysis and amniotic membrane nerve wrapping

Cited by 42 publications

References 40 publications

Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane prevents adhesions and promotes nerve repair in a rat model of sciatic nerve compression

Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane prevents adhesions and promotes nerve repair in a rat model of sciatic nerve compression

Barriers to Epineural Scarring: Role in Treatment of Traumatic Nerve Injury and Chronic Compressive Neuropathy

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

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Recurrent cubital tunnel syndrome treated with revision neurolysis and amniotic membrane nerve wrapping

Cited by 42 publications

References 40 publications

Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane prevents adhesions and promotes nerve repair in a rat model of sciatic nerve compression

Electrospun polycaprolactone (PCL)-amnion nanofibrous membrane prevents adhesions and promotes nerve repair in a rat model of sciatic nerve compression

Barriers to Epineural Scarring: Role in Treatment of Traumatic Nerve Injury and Chronic Compressive Neuropathy

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive™soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity

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Product

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About

Evaluation of postoperative outcomes in patients following multi-level surgical reconstructions with the use Avive^™soft tissue membrane on nerve after traumatic injury of the upper extremity and lower extremity