Revision Decompression and Collagen Nerve Wrap for Recurrent and Persistent Compression Neuropathies of the Upper Extremity

Soltani, Ali M.; Allan, Bassan J.; Best, Matthew J.; Mir, Haaris; Panthaki, Zubin J.

doi:10.1097/sap.0b013e3182956475

Cited by 70 publications

(64 citation statements)

References 44 publications

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“…To overcome this problem, collagen materials have recently been developed as an alternative to autologous veins . Vein wrapping was first employed in the upper extremity to avoid scarring in peripheral nerve injury .…”

mentioning

confidence: 99%

Wrapping With Basic Fibroblast Growth Factor‐Impregnated Collagen Sheet Reduces Rat Sciatic Nerve Allodynia

Mukai

Uchida

Hirosawa

et al. 2019

Journal Orthopaedic Research

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Autologous vein wrapping is used to treat recurrent chronic constriction neuropathy and traumatic peripheral nerve injury. However, its use is restricted due to the inability to obtain sufficiently long veins for larger grafts. We previously reported that vein‐derived basic fibroblast growth factor (bFGF) promotes heme oxygenase‐1 (HO‐1), which reduces allodynia via its anti‐inflammatory properties. To mimic vein wrapping, we developed a collagen sheet impregnated with bFGF. Chronic constriction injury (CCI) was induced in male Wistar rats as a model of sciatic nerve injury, and the rats were divided into three groups: (i) untreated after CCI surgery (control group), (ii) treated with a collagen sheet wrap impregnated with phosphate‐buffered saline (PBS/CS group), and (iii) treated with a collagen sheet wrap impregnated with bFGF (bFGF/CS group). Pain behavior (von Frey test) was evaluated on postoperative days (PODs) 1, 5, 7, and 14. Quantitative polymerase chain reaction was conducted on sciatic nerve RNA to quantify HO‐1 gene, Hmox1, expression. Enzyme‐linked immunosorbent assay were used to determine HO‐1 protein levels on POD 1. von Frey testing showed significantly greater pain hypersensitivity in the control and PBS/CS groups than the bFGF/CS group. In the bFGF/CS group, Hmox1 messenger RNA and HO‐1 protein levels were significantly increased in the sciatic nerve compared with the control and PBS/CS groups on PODs 1 and 5 and POD 1, respectively. The bFGF/CS group showed decreased allodynia and HO‐1 induction, as observed with vein wrapping. Therefore, local application of bFGF may be an alternative treatment strategy for compressive neuropathy and peripheral nerve trauma in clinical settings. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2258–2263, 2019

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mentioning

confidence: 99%

Wrapping With Basic Fibroblast Growth Factor‐Impregnated Collagen Sheet Reduces Rat Sciatic Nerve Allodynia

Mukai

Uchida

Hirosawa

et al. 2019

Journal Orthopaedic Research

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“…Collagen has both supportive animal and human data. 69 Porcine SIS (AxoGen, Inc., Alachua, FL) prevented adhesion formation around rabbit sciatic nerves at 1, 2, and 6 mo after implantation. Kim et al 68 demonstrated decreased connective tissue formation at the repair site, but no other significant difference between wrapped and nonwrapped rodent nerve repairs.…”

Section: Off-the-shelf Optionsmentioning

confidence: 99%

Different nerve grafting and wrapping options in upper extremity surgery

Isaacs

McMurtry

2014

Current Orthopaedic Practice

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Scar tissue can interfere with axonal regeneration and ultimate nerve function. Resection of scar tissue, however, results either in a nerve defect (if the scar tissue is intraneural) or the potential for recurrent extraneural scarring. Both biologic and off-the-shelf options exist for bridging short nerve gaps though understanding their limitations will improve the chances of successful application. Similarly, an appreciation of the available biologic and off-the-shelf nerve wrapping options can facilitate choosing the most appropriate adhesion barrier.

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“…[30,76] Reisman and Dellon [58] Abductor digiti minimi Median Pain reduction in 11/12 patients (91) Strickland et al [59] Hypothenar fat pad flap Median Excellent results in alleviating recalcitrant idiopathic CTS (95 satisfaction in 62 patients) Rose [60] Palmaris brevis muscle flap Median Complete pain relief in all patients (13 hands) (100) Jones [61] Pedicled or free flaps Median/ulnar Pain reduction in 7/9 patients (78) Giunta et al [62] Hypothenar fat pad flap Median Pain reduction in 8/9 patients (89) Frank et al [63] Hypothenar fat pad flap Median Pain reduction in 8/9 patients (89) Guillemot et al [64] Fat graft Median No pain reduction in 4 patients Mathoulin et al [65] Hypothenar fat pad flap Median Pain resolution in 41/45 patients (98) De Smet and Vandeputte [66] Hypothenar/ulnar fat pad flap Median Pain reduction in 9/14 patients (64) Dahlin et al [67] Pedicled ulnar, dorsal forearm flaps Free groin, scapular, lateral arm flaps Median Pain reduction in 10/14 patients (71) Goitz and Steichen [54] Free omental flaps Median Pain reduction in 7/11 patients (63) Luchetti et al [68] Fascial and fasciocutaneous island flaps (hypothenar fat pad, forearm radial artery, forearm ulnar artery, ulnar fascial fat, and posterior interosseous) Median Four point VAS score reduction in 23/25 patients (92) Craft et al [69] Hypothenar fat pad flap Median Pain resolution in 83% of 28 patients Fusetti et al [70] Hypothenar fat pad flap Median Pain reduction in 18/20 patients (90) Elliot et al [71] Vascularized forearm fascial flap Median/ulnar Pain resolution in 8/14 patients (57) Soltani et al [43] Collagen: neurolysis + collagen wrap Median/ulnar Resolution/improvement in 4 patients (median) Resolution in 3/4 patients (cubital tunnel syndrome) Espinoza et al [72] Microneurolysis alone versus ADCON/TN Median/ulnar Pain reduction in 80% of 54 patients Atzei et al [35] Neurolysis or nerve repair with Hyaloglide (R) Hand nerves Pain reduction quicker with Hyaloglide (R) 14 patients treated with HA versus 16 treated without gel Varitimidis et al [73] Autologous vein Median Pain reduction in 14/15 patients (93) Masear [74] Vein: autologous+allograft Median and various peripheral nerves…”

Section: Scar Neuritis and Outcomes: Literature Reviewmentioning

confidence: 99%

“…Its effectiveness is similar to that of other anti-adhesion devices, but it entails a lower fewer risk of complications compared to wrapping the nerve in autologous tissue such as vein (Neura Wrap; Integra LifeSciences, Plainsboro, NJ, USA). [43] There are therefore several different types of anti-adhesion devices, but scant information as to which is the most effective at the clinical and preclinical level, even though all seem to limit perineural scarring formation without any particular side effects. A major advantage is their fast application and less invasive surgical dissection, without the need for further procedures (and possible attendant injury), which considerably reduces operating time compared to the surgical approaches described above.…”

Section: Surgical Management After Neurolysis Commercial Gels and Antmentioning

confidence: 99%

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Painful scar neuropathy: principles of diagnosis and treatment

Tos¹,

Crosio²,

Pugliese³

et al. 2015

Plast Aesthet Res

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Nerve-tissue interactions are critical. Peripheral nerve injuries may involve intraneural and extraneural scar formation and affect nerve gliding planes, sometimes leading to complex clinical presentations. All of these pathological entities involve pain as the main clinical symptom and can be subsumed under the term "painful scar neuropathy". The authors review the literature on treatment approaches to peripheral nerve scar neuropathy and the outcomes of neurolysis-associated procedures and propose a simple classification and a therapeutic approach to scar neuropathy. The search retrieved twenty-one papers, twenty of which reported pain reduction or resolution with various techniques. There is no consensus on the best therapeutic approach to neuropathic pain due to scar tethering. Most authors report good or excellent results with different techniques, from nerve wrapping with anti-adhesion devices to nerve coverage or wrapping with vascularized tissue. The authors' classification of and therapeutic approach to peripheral nerve scar lesions aims at promoting a logical approach based on the analysis of lesion type (perineural, or endoneural and perineural), pain type (due to traction or external trauma, pain at rest), and number of previous operations. Patients need to be informed that multiple procedures may be required, that outcomes may be partial, and that surgery can potentially worsen preoperative conditions. The review found no evidence for the best therapeutic approach to scar neuropathy, but there is consensus on a multidisciplinary approach.

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Revision Decompression and Collagen Nerve Wrap for Recurrent and Persistent Compression Neuropathies of the Upper Extremity

Cited by 70 publications

References 44 publications

Wrapping With Basic Fibroblast Growth Factor‐Impregnated Collagen Sheet Reduces Rat Sciatic Nerve Allodynia

Wrapping With Basic Fibroblast Growth Factor‐Impregnated Collagen Sheet Reduces Rat Sciatic Nerve Allodynia

Different nerve grafting and wrapping options in upper extremity surgery

Painful scar neuropathy: principles of diagnosis and treatment

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