Use of poly dl-lactide-ε-caprolactone (Neurolac) conduit for enveloping traumatic neuromas

Taneerananon, Tonkid; Hussain, Muhammad Ali; Jhattu, Hardeep; Li, Jana; Klaassen, Mike; Milovic, Vladimire

doi:10.1007/s00238-013-0807-6

Cited by 5 publications

(12 citation statements)

References 21 publications

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“…Taneerananon et al have described the use of a NEUROLAC nerve guide, which is composed of the same bioresorbable material as NEUROCAP, formed as a cap around the severed nerve end by means as a capping device. 15 The positive experiences in that study are emphasized by the current study results of a bioresorbable nerve capping device in a rat model, where a significantly lower number of neuroma occurrence was found in the NEUROCAP group when compared with the control group where the transected proximal nerve end was left in situ without treatment.…”

Section: Discussionmentioning

confidence: 72%

“…13 Nerve capping after stump excision has been well documented in the literature as an effective and widely used means of preventing symptomatic neuroma formation by modulating fiber outgrowth. 6,14,15 The nerve cap forms a physical barrier that isolates the nerve from the surrounding inflammation and scar tissue. This barrier also serves to block the surrounding growth factors so as to change the regenerative response.…”

Section: Discussionmentioning

confidence: 99%

“…Overall, the results in this rat sciatic nerve study confirm the findings of previous studies that indicate the preventive effect of a barrier around a severed nerve end to prevent formation of end-neuroma. 15,16…”

Section: Discussionmentioning

confidence: 99%

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2021

Journal of Reconstructive Microsurgery Open

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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2021

Journal of Reconstructive Microsurgery Open

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“…Epineural caps have been used in various studies, but the consistent problem of axonal escape remains. [14][15][16] In history, silicone nerve capping devices have been used but have been linked to adverse events resulting from the use of silicone and requiring removal of the device. 6 These experiences indicated a need for nonsilicone and bioresorbable nerve capping devices.…”

Section: Discussionmentioning

confidence: 99%

Neuroma Prevention and Implantation Effects of NEUROCAP in Rat Sciatic Nerve Model

Peterson

Vries

Collins³

et al. 2021

Journal of Reconstructive Microsurgery Open

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Introduction Symptomatic neuroma with neuropathic pain can develop following peripheral nerve injury. Current interventions for symptomatic neuroma have unpredictable results. NEUROCAP (Polyganics, Groningen, The Netherlands) is a bioresorbable nerve capping device intended to protect a peripheral nerve end and separate the nerve from the surrounding environment, to prevent the recurrence of a symptomatic neuroma. Materials and Methods This study aims to assess the implantation effects of the NEUROCAP device in a rat sciatic nerve model during 12 months (±2 days). Forty-one adult male Sprague-Dawley rats were used in this study. They were randomly divided into a capping or test group, or a noncapping or control group for different time points of survival (12 weeks, 6 months, and 12 months). The objective of this study was evaluated regarding procedural data, adverse events, clinical observations, and histopathology. Results The overall general health of the animals was adequate throughout the study, with the exception of autotomy during the first 4 months of survival. Eight animals were euthanized early due to autotomy, excluded from the study and seven of them have been replaced. Autotomy was an expected outcome and a known limitation of the animal model, particularly as this was a full sciatic nerve transection model. Neuroma formation was observed in the control group while there was no neuroma formation present in the test group. The control group showed increased nerve outgrowth and more chaotic fascicles in comparison with the test group. The test group also had a higher percentage of myelinated fibers compared to the control group. These results indicate a preventive mode of action of the NEUROCAP with regard to neuroma formation after nerve transection in a rat sciatic nerve model. Conclusion The results indicate that NEUROCAP is safe and effective in preventing the recurrence of neuroma formation and inhibiting nerve outgrowth.

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“…A neuroma is a benign neoplasm mainly composed of disorganized nerve fibers arising from injured nerves 1 . Typically related to trauma, neuromas can develop in intact nerves (neuroma-in-continuity) or transected nerve ends (end-neuroma).…”

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confidence: 99%

Surgical Treatment of Symptomatic End-Neuroma With a New Bioresorbable Copolyester Nerve Capping Device

et al. 2023

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Background Neuroma-induced neuropathic pain is associated with loss of function and reduced quality of life. No consistently effective standard-of-care treatment has been defined. Neurocap, a bioresorbable nerve capping device, has been designed to isolate the nerve stump from surrounding tissues to reduce development of symptomatic end-neuromas. Methods Patients with peripheral symptomatic end-neuromas were included in a prospective, multicenter, single-arm design. Data were collected presurgery up till 24 months postsurgery. Eligible patients with neuromas were identified based on blocks using anesthetic. Intervention included surgical excision and capping of the transected proximal nerve end with the Neurocap. Main outcome measures were pain, function, recurrence of symptomatic neuroma, use of analgesics, and adverse events. Results In total, 73 patients with 50 upper-extremity and 23 lower-extremity end-neuromas were enrolled. End-neuromas were predominately located in the digits and lower leg. Statistical power of the study outcomes was preserved by 46 of 73 patients completing 24-month follow-up. The mean VAS-Pain score at baseline was 70.2 ± 17.8 (scale 0–100) and decreased significantly to 31 ± 32.5 (P < 0.001). Function significantly improved over time. The recurrence rate of confirmed symptomatic neuroma was low (2 of 98 capped nerves). Adverse event rate was low and included pain and infection; there were no unexpected device-related adverse events. Most patients reported lower use of nonsteroidal anti-inflammatory drugs, opioids, and antineuropathic medications at last follow-up compared with baseline. Conclusions End-neuroma treatment with excision and capping resulted in long-term significant reduction in reported pain, disability, and analgesic medication use. Adverse event rate was low.

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Use of poly dl-lactide-ε-caprolactone (Neurolac) conduit for enveloping traumatic neuromas

Cited by 5 publications

References 21 publications

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Untitled

Neuroma Prevention and Implantation Effects of NEUROCAP in Rat Sciatic Nerve Model

Surgical Treatment of Symptomatic End-Neuroma With a New Bioresorbable Copolyester Nerve Capping Device

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