The Interfascicular Nerve-Grafting of the Median and Ulnar Nerves

Millesi, H.; Meissl, G.; Berger, A.

doi:10.2106/00004623-197254040-00004

Cited by 465 publications

(127 citation statements)

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“…The methods for repairing nerve gaps can be roughly classified into two categories: 1) bridging, which includes grafting and tubulization techniques, and 2) under tension end-to-end suturing of the nerve stumps. The former techniques are more effective, since they avoid tension across the repair site (Millesi et al 1972;Battiston 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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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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“…[3] After nerve trauma, the standard clinical operating procedure is to appose the two nerve ends and suture them together without generating tension where possible. If the gap is large, such that tensionless apposition is not possible, a nerve autograft -typically the patient's own sural nerve -is used as a bridge.…”

Section: Introductionmentioning

confidence: 99%

Tissue Engineering Strategies Designed to Realize the Endogenous Regenerative Potential of Peripheral Nerves

et al. 2009

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http://doi.wiley.com/10.1002/adma.v21:32/33 Bridging peripheral nerve gaps without the use of autografts has significant clinical importance. But in order to rationally design novel scaffolds, a good understanding of the nerve regeneration process is vital. Appropriate amount of structural and chemical cues are required to stimulate the endogenous mechanisms of repair and functional recovery. Synthetic and natural materials present various opportunities to induce the growth of supporting cells as well as promote axon regeneration. An overview of tissue engineering strategies currently being explored that stimulate the different steps of the regenerative sequence is presented.

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“…We present the results of a similar longitudinal study to assess the neurophysiological changes that occurred during the recovery period of 16 severely injured peripheral nerves of the forearm which were repaired with autogenous sural nerve grafts using the technique described by Millesi et al in 1972. …”

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confidence: 99%