Treatment of Acute Peripheral Nerve Injuries: Current Concepts

Isaacs, Jonathan

doi:10.1016/j.jhsa.2009.12.009

Cited by 122 publications

(98 citation statements)

References 49 publications

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“…Despite better fascicle alignment, this procedure is no better than epineural repair in functional outcomes and in fact is associated with more traumas and scaring [30,63,66]. Complementary assistance techniques of histologic staining using acetylcholine esterase and carbonic anhydrase, electrical stimulation during the procedure in awaken patients and visual observation of surface vessels, are visual orientations to the surgeon that grant the success of the procedure [63,67]. Another possible approach is the use of tissue adhesives such as fibrin glue to supplement or replace sutures, creating a gel-like clot at the nerve ends.…”

Section: Direct Nerve Repairmentioning

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: Direct Nerve Repairmentioning

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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“…uccessful repair of injured peripheral nerves remains a serious clinical challenge, especially in the case of nerve tissue loss, when a simple direct repair is not feasible due to the gap created between the transected nerve ends [1,2]. The current clinical gold standard for such injuries is to use an autologous nerve graft, but this creates donor site morbidity with loss of sensation and consequent scarring.…”

mentioning

confidence: 99%

Stimulating the Neurotrophic and Angiogenic Properties of Human Adipose-Derived Stem Cells Enhances Nerve Repair

Kingham

Kolar

Novikova

et al. 2014

Stem Cells and Development

183

147

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“…Axonotmesis describes axonal disruption with intact supportive tissue. The regeneration time is slower but can be estimated at a rate of 1 mm of regeneration per day (Isaacs, 2010). Higher-grade axonotmesis and neurotmesis (i.e.…”

Section: Classificationmentioning

confidence: 99%

“…Serial examinations can help to classify the injury. However, over time the denervated distal nerve tissue and muscle will lose their ability to support axonal regrowth; therefore, surgical reconstruction should be done as early as possible (Isaacs, 2010). …”

Section: Classificationmentioning

confidence: 99%

“…The ideal setting for direct repair is an injury zone with a good blood supply and soft tissue coverage, and when repair is carried out in the first few days following injury. A gap of more than 2.5 cm at the site of injury will usually require nerve grafting (Isaacs, 2010). End-to-end repair should be carried out by suturing the epineurium together with fine non-absorbable sutures in a tension-free fashion.…”

Section: Direct End-to-end Nerve Repairmentioning

confidence: 99%

See 1 more Smart Citation

Textbook of Plastic and Reconstructive Surgery

Butler¹,

Ghali²,

Kalaskar³

2016

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A CIP catalogue record for this book is available from The British Library.This book is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. The user is advised to always check the product information and clinical procedures with the most up-to-date published product information and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or misuse or misapplication of material in this work.ISBN: 978-1-910634-37-0 (Hbk.) ISBN: 978-1-910634-38-7 (Pbk.) ISBN: 978-1-910634-39-4 (PDF) ISBN: 978-1-910634-40-0 (epub) ISBN: 978-1-910634-41-7 (mobi)

show abstract

Treatment of Acute Peripheral Nerve Injuries: Current Concepts

Cited by 122 publications

References 49 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

Stimulating the Neurotrophic and Angiogenic Properties of Human Adipose-Derived Stem Cells Enhances Nerve Repair

Textbook of Plastic and Reconstructive Surgery

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