scholarly journals Nerve Repair with Nerve Conduits: Problems, Solutions, and Future Directions

2018 ◽  
Vol 10 (02) ◽  
pp. 61-65 ◽  
Author(s):  
Ryan Rebowe ◽  
Ashley Rogers ◽  
Xuebin Yang ◽  
S. Kundu ◽  
Thomas Smith ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Repair ◽  
Functional Limitations ◽  
Donor Site ◽  
Clinical Problem ◽  
Donor Site Morbidity ◽  
Future Directions ◽  
Nerve Conduits ◽  
Attractive Option ◽  
The Common

AbstractNerve conduits are becoming increasingly popular for the repair of peripheral nerve injuries. Their ease of application and lack of donor site morbidity make them an attractive option for nerve repair in many situations. Today, there are many different conduits to choose in different sizes and materials, giving the reconstructive surgeon many options for any given clinical problem. However, to properly utilize these unique reconstructive tools, the peripheral nerve surgeon must be familiar not only with their standard indications but also with their functional limitations. In this review, the authors identify the common applications of nerve conduits, expected results, and shortcomings of current techniques. Furthermore, future directions for nerve conduit use are identified.

scholarly journals Peripheral Nerve Injury: Principles for Repair and Regeneration

2014 ◽  
Vol 8 (1) ◽  
pp. 199-203 ◽  
Author(s):  
Griffin M.F ◽  
Malahias M ◽  
Hindocha S ◽  
Wasim S Khan
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Nerve Repair ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Biological Research ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Nerve Conduits ◽  
Limb Trauma

Peripheral Nerve Injuries are one of the most common causes of hand dysfunction caused by upper limb trauma but still current management has remained suboptimal. This review aims to explain the traditional view of pathophysiology of nerve repair and also describe why surgical management is still inadequate in using the new biological research that has documented the changes that occur after the nerve injury, which, could cause suboptimal clinical outcomes. Subsequently presentation and diagnosis will be described for peripheral nerve injuries. When traditional surgical repair using end-to-end anastomosis is not adequate nerve conduits are required with the gold standard being the autologous nerve. Due to associated donor site morbidity and poor functional outcome documented with autologous nerve repair several new advancements for alternatives to bridge the gap are being investigated. We will summarise the new and future advancements of non-biological and biological replacements as well as gene therapy, which are being considered as the alternatives for peripheral nerve repair.

scholarly journals Material advancement in tissue-engineered nerve conduit

2021 ◽  
Vol 10 (1) ◽  
pp. 488-503
Author(s):  
Wufei Dai ◽  
Yating Yang ◽  
Yumin Yang ◽  
Wei Liu
Keyword(s):  
Peripheral Nerve ◽  
Animal Studies ◽  
Nerve Repair ◽  
Donor Site ◽  
Life Quality ◽  
Nerve Grafts ◽  
Synthetic Materials ◽  
Nerve Conduits ◽  
Extracellular Matrix Components

Abstract Peripheral nerve injuries resulting from various traumatic events can cause mobility problems and sensory impairment, jeopardizing patients’ life quality and bringing serious economic burdens. Due to the shortcomings of autologous nerve grafts, such as limited tissue sources, unmatched size, and loss of innervation at the donor site, tissue-engineered nerve grafts using both natural and synthetic materials have been employed in the treatment of peripheral nerve defect and to promote nerve regeneration. Apart from traditional advantages such as good biocompatibility and controllable degradation, the development of fabrication technology and the advancement in material science have endowed tissue-engineered nerve conduits with upgraded properties such as biomimetic surface topography, extracellular matrix components, neurotrophic factors, and cell seeding, or a conduit with micropores on the surface for substance exchange and/or with fillers inside for microenvironment simulation. This article reviews recent progress in the biomaterials employed in fabricating tissue-engineered nerve conduits, in vitro characterization, and their applications in nerve repair in animal studies as well as in clinical trials.

Regenerative effects of adipose-tissue-derived stem cells for treatment of peripheral nerve injuries

2014 ◽  
Vol 42 (3) ◽  
pp. 697-701 ◽  
Author(s):  
Mallappa K. Kolar ◽  
Paul J. Kingham
Keyword(s):  
Stem Cells ◽  
Adipose Tissue ◽  
Peripheral Nerve ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Donor Site ◽  
Short Review ◽  
Donor Site Morbidity ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Peripheral nerve injuries are a common occurrence affecting the nerves found outside the central nervous system. Complete nerve transections necessitate surgical re-anastomosis, and, in cases where there is a significant gap between the two ends of the injured nerve, bridging strategies are required to repair the defect. The current clinical gold standard is the nerve graft, but this has a number of limitations, including donor site morbidity. An active area of research is focused on developing other techniques to replace these grafts, by creating tubular nerve-guidance conduits from natural and synthetic materials, which are often supplemented with biological cues such as growth factors and regenerative cells. In the present short review, we focus on the use of adipose-tissue-derived stem cells and the possible mechanisms through which they may exert a positive influence on peripheral nerve regeneration, thereby enabling more effective nerve repair.

Luminal Fillers in Nerve Conduits for Peripheral Nerve Repair

2006 ◽  
Vol 57 (4) ◽  
pp. 462-471 ◽  
Author(s):  
Michael B. Chen ◽  
Feng Zhang ◽  
William C. Lineaweaver
Keyword(s):  
Peripheral Nerve ◽  
Nerve Repair ◽  
Peripheral Nerve Repair ◽  
Nerve Conduits

Spatially Controlled Delivery of Neurotrophic Factors in Silk Fibroin–Based Nerve Conduits for Peripheral Nerve Repair

2011 ◽  
Vol 67 (2) ◽  
pp. 147-155 ◽  
Author(s):  
Yen-Chih Lin ◽  
Mostafa Ramadan ◽  
Marie Hronik-Tupaj ◽  
David L. Kaplan ◽  
Brian J. Philips ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Silk Fibroin ◽  
Neurotrophic Factors ◽  
Nerve Repair ◽  
Controlled Delivery ◽  
Peripheral Nerve Repair ◽  
Nerve Conduits

Surgical Technique and Outcomes of Reconstruction for Blauth Type III Thumb Hypoplasia

Hand ◽  
2021 ◽  
pp. 155894472110387
Author(s):  
Morad Chughtai ◽  
Kara McConaghy ◽  
Xem Bui ◽  
Grzegorz J. Kwiecien ◽  
William H. Seitz
Keyword(s):  
Hand Function ◽  
Functional Limitations ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Reconstruction Procedure ◽  
Type Iii ◽  
Cultural Preferences ◽  
Surgical Options ◽  
Hypoplastic Thumb ◽  
Postoperative Improvement

Background Historically, amputation and pollicization has been the recommended surgical treatment for Blauth type III hypoplastic thumbs. However, due to aesthetic objections or cultural preferences, some parents seek out alternative surgical options. The present study describes a nontraditional technique that preserves and augments the hypoplastic thumb. Methods Patient charts were retrospectively reviewed to identify patients with Blauth type III hypoplastic thumbs who underwent thumb reconstruction at our institution from 2008 to 2018. The reconstruction procedure involved toe phalanx transfer, staged tendon transfers, and lengthening as needed. Motion was assessed categorically as ability to flex, extend, or oppose the thumb. Functionality was assessed as ability to pinch and grasp with the surgical hand. Patient- or parent-reported improvement in thumb function was also recorded. Results Of the 13 patients, 100% could flex, extend, and oppose the thumb to some degree. Eleven patients (85%) had functional one-handed grasp, and 9 (69%) had a functional pinch. Eleven patients (85%) reported no functional limitations of the operative hand. Thirteen patients (100%) reported improvement in hand function after surgery as compared to pre-operatively. There were 2 minor complications (15%), both of which resolved after intervention. No patients experienced donor-site morbidity. Conclusions Reconstruction of Blauth III thumbs is a nontraditional technique that allows for digit retention by salvaging the hypoplastic thumb. In the present study, the majority of patients had functional thumbs and all reported postoperative improvement. Overall, our results suggest that reconstruction is a viable surgical option for Blauth III hypoplastic thumbs.

Fifth toe Fillet Flap for Wound Coverage of Non-Healing Ulcer of the Foot: Surgical Technique and a Case Report

2020 ◽  
Vol 9 (2) ◽  
pp. 7-10
Author(s):  
Sunny Chaudhary ◽  
Shivakumar A Bali ◽  
Arvind Singh ◽  
R K Siddharth
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Functional Limitations ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Healing Ulcer ◽  
Wound Coverage ◽  
Fillet Flap ◽  
Plantar Aspect ◽  
Partial Amputation

Fillet flap is one of the options in the treatment of diabetic non-healing ulcers. The advantages of the fillet flap include the absence of donor site morbidity, excellent durability and preventing the need for more proximal amputation. A 56-year-old farmer presented to the out-patient department with complaints of a non-healing ulcer on the sole of the right foot for the past 7 months which was managed conservatively. A fifth ray partial amputation and a rotational flap of the redundant fifth finger for wound coverage were done. The wound healing was uneventful and the sutures were removed after two weeks. At the latest follow-up of 2 years, the patient was able to walk independently without pain and without any functional limitations. This case report describes the surgical technique of the lateral lesser toe fillet flap for wound closure on the plantar aspect of foot as an alternative to secondary healing or more proximal amputations.

Artificial nerve conduits in peripheral-nerve repair

2005 ◽  
Vol 41 (3) ◽  
pp. 193 ◽  
Author(s):  
Henryk J. Salacinski ◽  
Ruben Y. Kannan ◽  
Peter E. M. Butler ◽  
Alexander M. Seifalian
Keyword(s):  
Peripheral Nerve ◽  
Nerve Repair ◽  
Peripheral Nerve Repair ◽  
Nerve Conduits

scholarly journals Peripheral Nerve Repair with Cultured Schwann Cells: Getting Closer to the Clinics

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Maria Carolina O. Rodrigues ◽  
Antonio Antunes Rodrigues ◽  
Loren E. Glover ◽  
Julio Voltarelli ◽  
Cesario V. Borlongan
Keyword(s):  
Bone Marrow ◽  
Peripheral Nerve ◽  
Schwann Cells ◽  
Nerve Repair ◽  
Experimental Studies ◽  
Experimental Treatment ◽  
Mesenchymal Cells ◽  
Nerve Conduits ◽  
Cultured Schwann Cells

Peripheral nerve injuries are a frequent and disabling condition, which affects 13 to 23 per 100.000 persons each year. Severe cases, with structural disruption of the nerve, are associated with poor functional recovery. The experimental treatment using nerve grafts to replace damaged or shortened axons is limited by technical difficulties, invasiveness, and mediocre results. Other therapeutic choices include the adjunctive application of cultured Schwann cells and nerve conduits to guide axonal growth. The bone marrow is a rich source of mesenchymal cells, which can be differentiatedin vitrointo Schwann cells and subsequently engrafted into the damaged nerve. Alternatively, undifferentiated bone marrow mesenchymal cells can be associated with nerve conduits and afterward transplanted. Experimental studies provide evidence of functional, histological, and electromyographical improvement following transplantation of bone-marrow-derived cells in animal models of peripheral nerve injury. This paper focuses on this new therapeutic approach highlighting its direct translational and clinical utility in promoting regeneration of not only acute but perhaps also chronic cases of peripheral nerve damage.

Nerve Conduits in Peripheral Nerve Repair

2005 ◽  
Vol 10 (1) ◽  
pp. 125-133 ◽  
Author(s):  
C HERMAN ◽  
J DIAZ ◽  
B STRAUCH
Keyword(s):  
Peripheral Nerve ◽  
Nerve Repair ◽  
Peripheral Nerve Repair ◽  
Nerve Conduits
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