Free Vascularized Nerve Grafts

Nerve injuries are a common pathology in hand trauma. The consequences are drastic both for patients and doctors/medical system. In many cases direct coaptation is impossible. A nerve graft should be used in the case of a neuroma, trauma or tumor, for restoration of nervous influx. The aim of this study is demonstrate that by grafting restant nerve stumps with muscle-in-vein nerve grafts we obtain good result in terms of functional and sensibility recovery and also our method �window-vein� is a good way of prolonging nerve grafts. The method of study is experimental. We worked in the laboratory in optimal conditions for carrying out of muscles-in-vein nerve grafts (nerve grafts size 1.5 cm-3 cm). We used acellular muscle grafts with the chemical extraction method.The study was conducted on experimental animals (Wistar male rats).We used 30 experience animals in 3 equal groups (classical group and muscle-in-vein nerve grafts-2 nerve grafts of 1,5 cm central sutured and the third group with muscle-in-vein nerve grafts, window-vein method, 3 cm). At 4 and respectively 6 weeks postoperative at the quality tests we observed the progress with the footprint test. The operated hind in comparison with the healthy hind was 86% recovered and similar with classic nerve grafts. Quantitatively the number of regenerated axons in the group with muscle-in-vein nerve grafts was significant bigger in comparison with the classical group (15%).The method using muscle-in-vein nerve graft with windows-vein it�s a good alternative for nerve grafting in comparison with classical nerve grafting. When the local possibilities are limited, this method is good for prolonging the grafts. The relationship between cost and benefit in this case it�s an advantage because we use the local resources of the affected area. The motor results of nerve grafting ingroup 2 in comparison with group 3 were similar and in some cases better in group 1. Grafting with MVNG offers a better alternative for donor site regeneration in comparison with classical nerve grafts. This method is useful to prolong nerve grafts without adding morbidity.

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Mesenchymal Stem Cells Derived from Wharton’s Jelly Can Differentiate into Schwann Cell-Like Cells and Promote Peripheral Nerve Regeneration in Acellular Nerve Grafts

Tissue Engineering and Regenerative Medicine ◽

10.1007/s13770-020-00329-6 ◽

2021 ◽

Author(s):

Soon Jin Choi ◽

Suk Young Park ◽

Young Ho Shin ◽

Seung-Ho Heo ◽

Kang-Hyun Kim ◽

...

Keyword(s):

Stem Cells ◽

Mesenchymal Stem Cells ◽

Schwann Cell ◽

Peripheral Nerve ◽

Nerve Regeneration ◽

Peripheral Nerve Regeneration ◽

Wharton’S Jelly ◽

Wharton's Jelly ◽

Nerve Grafts

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Complete Femoral Nerve Transection with Sural Nerve Cable Graft in a 21-Month-Old Child

Journal of Neurosciences in Rural Practice ◽

10.4103/jnrp.jnrp_235_18 ◽

2019 ◽

Vol 10 (01) ◽

pp. 139-141 ◽

Cited By ~ 1

Author(s):

Pranati Pillutla ◽

Evan Nix ◽

Benjamin Wallace Elberso ◽

Laszlo Nagy

Keyword(s):

Peripheral Nerve Injury ◽

Sural Nerve ◽

Pediatric Population ◽

Femoral Nerve ◽

Severe Trauma ◽

Nerve Transection ◽

Effective Management ◽

Surrounding Area ◽

Regenerative Capacity ◽

Nerve Grafts

ABSTRACTSevere peripheral nerve injury occasionally requires urgent nerve grafting especially with significant separation of the proximal and distal ends of the injured nerve. Proper reinnervation to provide continued sensory and motor function is essential especially in the pediatric population. These patients would suffer lifelong disability without correction, yet have significantly improved regenerative capacity with prompt and effective management, making nerve grafts an ideal choice for complete nerve transection. This case report describes the successful sural nerve cable graft reinnervation of a transected femoral nerve in a 21-month-old male. This procedure was made difficult by severe trauma to the surrounding area with laceration of the femoral artery, significant separation of the femoral nerve ends, and the compact anatomy of such a young patient.

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Vascularized and nonvascularized nerve grafts in dogs

Journal of Oral and Maxillofacial Surgery ◽

10.1016/0278-2391(89)90655-1 ◽

1989 ◽

Vol 47 (8) ◽

pp. 123

Author(s):

John Provenzano

Keyword(s):

Nerve Grafts

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Peripheral Nerve Transplantation: The Effects of Predegenerated Grafts and Immunosuppression

Journal of Neural Transplantation and Plasticity ◽

10.1155/np.1992.39 ◽

1992 ◽

Vol 3 (1) ◽

pp. 39-49 ◽

Cited By ~ 23

Author(s):

Thomas E. Trumble

Keyword(s):

Cyclosporin A ◽

Donor Site ◽

Flexion Contracture ◽

Brown Norway ◽

Control Group ◽

Neurologic Recovery ◽

Nerve Grafts ◽

Nerve Transplantation ◽

Joint Flexion ◽

Tissue Rejection

Research involving nerve transplantation has shown that tissue rejection limits the neurologic recovery unless the host is immunosuppressed. This study investigates an alternative to permanent or temporary immunosuppression using a rat model with nerve transplants from Brown- Norway rat donors to bridge defects in the sciatic nerve of Lewis rat recipients as these two inbred strains differ at both major and minor histocompatibility loci.The specific aim of this study was to evaluate if predegenerated nerve grafts decreased the tissue rejection and improved the neurologic recovery of animals with allogenic nerve grafts to avoid the problems associated with either short- or long-term immunosuppression. The animals in the experimental groups received cyclosporin-A, predegencrated grafts, both, or neither. The predegenerated grafts were produced by division of the nerve three weeks prior to grafting to allow for Wallerian degeneration to occur. The outcome was assessed by measurements stressing functional recovery (sensory testing, gait analysis, joint flexion contracture), studies of muscle recovery (muscle weight and hydroxyproline concentration), and histologic studies (axonal counts and inflammatory reaction). The animals receiving the predegenerated grafts without cyclosporin did have an improved recovery (joint flexion contracture 35° ± 8 ° and hydroxyproline ratio 1.52 ± 0.16) as compared to the joint flexion contractures and hydroxyproline ratios of the allograft group of animals without either cyclosporin- A or pretreatment and the ungrafted control group (47° ± 18°, 1.68 ± 0.34, and 53° ±15° ,4.50 ± 0.27, respectively, p < 0.01). However, all the isograft groups and allograft groups with cyclosporin-A, regardless of whether the graft had been predegenerated or not, had greater neurologic recovery than the allograft group with predegenerated grafts but without cyclosporin-A by the same parameters (p < 0.01). Allograft groups with short-term immunosuppression with cyclosporin-A did as well as isograft groups, and isograft groups with predegenerated grafts did not do any better than isografts without pretreatment (p <0.01).Clinical Relevance:Predegenerated nerve allografts will allow for greater neurologic recovery than standard nerve allografts avoiding the complications of immunosuppression, but the level of recovery is less than that of recipients of nerve allografts with immunosuppression. Nerve transplants would avoid the problems of neurologic deficits at the donor site and allow multiple large deficits to be treated easily.

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