Peripheral Nerve Injuries: A Comparative Study of the Anatomical and Functional Results Following Primary Nerve Repair in Chimpanzees

1968 ◽  
Vol 133 (4) ◽  
pp. 298-302 ◽  
Author(s):  
Thomas B. Ducker ◽  
George J. Hayes
Keyword(s):  
Peripheral Nerve ◽  
Comparative Study ◽  
Nerve Repair ◽  
Functional Results ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries

Primary Repair of Upper Extremity Peripheral Nerve Injuries: An NSQIP Analysis From 2010 to 2016

Hand ◽  
2021 ◽  
pp. 155894472110447
Author(s):  
Ryan Brennan ◽  
Jordan Carter ◽  
Gilberto Gonzalez ◽  
Fernando A. Herrera
Keyword(s):  
Peripheral Nerve ◽  
Upper Extremity ◽  
Complication Rate ◽  
Primary Repair ◽  
Nerve Repair ◽  
Multiple Injury ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Improvement Program ◽  
Injury Group

Background To identify the rate of 30-day complications after primary repair of upper extremity peripheral nerve injuries, associated diagnoses, and postoperative complication rate. Methods The American College of Surgeons National Surgical Quality Improvement Program database was reviewed from 2010 to 2016. Current Procedural Terminology codes consistent with primary nerve repair of the upper extremity were identified and included in the analysis. Patient demographics, comorbidities, type of procedure (elective/emergent), wound class, operative time, and 30-day complications were recorded. Patients with isolated upper extremity nerve injuries (isolated) were compared with those with peripheral nerve injuries in addition to bone, tendon, or soft tissue injuries (multiple). Results In all, 785 patients were identified as having upper extremity nerve repairs (0.16%). Of them, 64% were men and 36% were women; the average patient age was 40 years. The most common indication for surgery was injury to the digits (54% of cases). Thirty-day adverse events occurred in 3% of all cases. Isolated nerve injury occurred in 43% of patients, whereas 57% had additional injuries. The multiple injury group had a significantly higher complication rate compared with the isolated group (1% vs 4.5%) ( P = .007). Repair of tendon at forearm or wrist was the most common concurrent procedure performed. Conclusions Thirty-day complications among upper extremity peripheral nerve injuries are low, accounting for 3% of cases. Return to the operating room accounted for nearly half of all complications. Patients in the multiple injury group accounted for more than half of these and had a significantly higher complication rate compared with patients with isolated nerve injuries.

Use of electrospinning to construct biomaterials for peripheral nerve regeneration

2016 ◽  
Vol 27 (7) ◽  
pp. 761-768 ◽  
Author(s):  
Qi Quan ◽  
Biao Chang ◽  
Hao Ye Meng ◽  
Ruo Xi Liu ◽  
Yu Wang ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Functional Recovery ◽  
Nerve Repair ◽  
Peripheral Nerve Regeneration ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
New Process ◽  
Recent Developments ◽  
Innovative Techniques

AbstractA number of limitations associated with the use of hollow nerve guidance conduits (NGCs) require further discussion. Most importantly, the functional recovery outcomes after the placement of hollow NGCs are poor even after the successful bridging of peripheral nerve injuries. However, nerve regeneration scaffolds built using electric spinning have several advantages that may improve functional recovery. Thus, the present study summarizes recent developments in this area, including the key cells that are combined with the scaffold and associated with nerve regeneration, the structure and configuration of the electrospinning design (which determines the performance of the electrospinning scaffold), the materials the electrospinning fibers are composed of, and the methods used to control the morphology of a single fiber. Additionally, this study also discusses the processes underlying peripheral nerve regeneration. The primary goals of the present review were to evaluate and consolidate the findings of studies that used scaffolding biomaterials built by electrospinning used for peripheral nerve regeneration support. It is amazing that the field of peripheral nerve regeneration continues to consistently produce such a wide variety of innovative techniques and novel types of equipment, because the introduction of every new process creates an opportunity for advances in materials for nerve repair.

scholarly journals Transplantation of autologous Schwann cells for the repair of segmental peripheral nerve defects

2009 ◽  
Vol 26 (2) ◽  
pp. E4 ◽  
Author(s):  
Brian Hood ◽  
Howard B. Levene ◽  
Allan D. Levi
Keyword(s):  
Peripheral Nerve ◽  
Schwann Cells ◽  
Recovery Of Function ◽  
Nerve Repair ◽  
Surgical Techniques ◽  
Sensory Nerve ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Cell Culture Techniques ◽  
Chronic Disability

Peripheral nerve injuries are a source of chronic disability. Incomplete recovery from such injuries results in motor and sensory dysfunction and the potential for the development of chronic pain. The repair of human peripheral nerve injuries with traditional surgical techniques has limited success, particularly when a damaged nerve segment needs to be replaced. An injury to a long segment of peripheral nerve is often repaired using autologous grafting of “noncritical” sensory nerve. Although extensive axonal regeneration can be observed extending into these grafts, recovery of function may be absent or incomplete if the axons fail to reach their intended target. The goal of this review was to summarize the progress that has occurred in developing an artificial neural prosthesis consisting of autologous Schwann cells (SCs), and to detail future directions required in translating this promising therapy to the clinic. In the authors' laboratory, methods are being explored to combine autologous SCs isolated using cell culture techniques with axon guidance channel (AGC) technology to develop the potential to repair critical gap length lesions within the peripheral nervous system. To test the clinical efficacy of such constructs, it is critically important to characterize the fate of the transplanted SCs with regard to cell survival, migration, differentiation, and myelin production. The authors sought to determine whether the use of SC-filled channels is superior or equivalent to strategies that are currently used clinically (for example, autologous nerve grafts). Finally, although many nerve repair paradigms demonstrate evidence of regeneration within the AGC, the authors further sought to determine if the regeneration observed was physiologically relevant by including electrophysiological, behavioral, and pain assessments. If successful, the development of this reparative approach will bring together techniques that are readily available for clinical use and should rapidly accelerate the process of bringing an effective nerve repair strategy to patients with peripheral nerve injury prior to the development of pain and chronic disability.

scholarly journals The Role of Current Techniques and Concepts in Peripheral Nerve Repair

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
K. S. Houschyar ◽  
A. Momeni ◽  
M. N. Pyles ◽  
J. Y. Cha ◽  
Z. N. Maan ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Nerve Regeneration ◽  
Clinical Application ◽  
Functional Recovery ◽  
Nerve Repair ◽  
Treatment Options ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Peripheral Nerve Repair

Patients with peripheral nerve injuries, especially severe injury, often face poor nerve regeneration and incomplete functional recovery, even after surgical nerve repair. This review summarizes treatment options of peripheral nerve injuries with current techniques and concepts and reviews developments in research and clinical application of these therapies.

The Epidemiology and Management of Upper Limb Peripheral Nerve Injuries in Modern Practice

1996 ◽  
Vol 21 (1) ◽  
pp. 4-13 ◽  
Author(s):  
R. M. R. McALLISTER ◽  
S. E. A. GILBERT ◽  
J. S. CALDER ◽  
P. J. SMITH
Keyword(s):  
Peripheral Nerve ◽  
Nerve Injury ◽  
Upper Limb ◽  
Primary Repair ◽  
Nerve Repair ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Frequency Distributions ◽  
South East England ◽  
Delayed Referral

This paper reports an epidemiological and clinical study of 813 patients with 1,111 peripheral nerve injuries who were treated for upper limb trauma, which included nerve injury, at two plastic surgery units in south-east England, predominantly between the years 1982 and 1991. The frequency distributions of the levels of nerve injury, and the causes of nerve injury in the sample, are presented, together with the surgical management and timing of nerve repair in these patients. 1,018 clinically suspected nerve injuries in 730 patients (91.6% of nerves, 89.8% of patients) were treated by primary nerve repair, elective delayed nerve repair or primary surgical exploration alone. Divisions of 93 nerves in 83 patients (8.3% of nerves, 10.2% of patients) were treated other than by primary repair or elective delayed repair, due to delayed referral from accident and emergency departments, resulting from missed or uncertain diagnosis at presentation or otherwise unaccounted delay in the initial referral.

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.

Peripheral Nerve Injuries- An Analysis of 75 Cases

JMS SKIMS ◽  
2010 ◽  
Vol 13 (1) ◽  
pp. 7-10
Author(s):  
Owais Habib ◽  
Adil Hafeez ◽  
Abdul Rashid Bhat
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Primary Repair ◽  
Nerve Repair ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Microsurgical Technique ◽  
Injured Nerve ◽  
Neural Damage ◽  
Civilian Practice

Background: Peripheral neural trauma is a common injury seen both in civilian practice and warfare.Majority of such neural damage is caused by glass cut. The agent causes extnesive damage to te underlying structures from an apparantly looking small incised wound.Material and Method: We explored the wonds of 75 patients under anaesthesia to look for injury to the underlying peripheral nerves. Upon identifying the injured nerve, primary repair using epineural microsurgical technique was carried out using very fine sutures and micro- instruments. The patients were followed sequentailly in the post operative period.Conclusion:When such a protocol was adhered to, the results of nerve repair were excellent in majority of the patients. J Med Sci 2010;13(1):7-10

scholarly journals Nerve grafting in peripheral nerve injuries

2003 ◽  
Vol 50 (1) ◽  
pp. 47-54
Author(s):  
Danica Grujicic ◽  
Miroslav Samardzic ◽  
Lukas Rasulic ◽  
Dragan Savic ◽  
Irena Cvrkota ◽  
...  
Keyword(s):  
Peripheral Nerve ◽  
Peripheral Nerves ◽  
Nerve Repair ◽  
Soft Tissue Injuries ◽  
Nerve Grafting ◽  
Peripheral Nerve Injuries ◽  
Nerve Injuries ◽  
Upper And Lower Extremities ◽  
Nerve Recovery

Autologous nerve grafting is the most commnly used operative technique in delayed primary, or secondary nerve repair after the peripheral nerve injuries. The aim of this procedure is to overcome nerve gaps that results from the injury itself, fibrous and elastic retraction forces, resection of the damaged parts of the nerve, position of the articulations and mobilisation of the nerve. In this study we analyse the results of operated patients with transections and lacerations of the peripheral nerves from 1979 to 2000 year. Gunshot injuries have not been analyzed in this study. The majority of the injuries were in the upper extremity (more than 87% of cases). Donor for nerve transplantation had usually been sural nerve, and only occasionally medial cutaneous nerve of the forearm was used. In about 93% of cases we used interfascicular nerve grafting, and cable nerve grafting was performed in the rest of them. Most of the grafts were 1 do 5 cm long (70% of cases). Functional recovery was achieved in more than 86% of cases, which is similar to the results of the other authors. Follow up period was minimum 2 years. We analyzed the influence of different factors on nerve recovery after the operation: patient?s age, location and the extent (total or partial) of nerve injury, the length of the nerve graft, type of the nerve, timing of surgery, presence of multiple nerve injuries and associated osseal and soft tissue injuries of the upper and lower extremities.

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