The Use of Degradable Nerve Conduits for Human Nerve Repair: A Review of the Literature

The management of peripheral nerve injury continues to be a major clinical challenge. The most widely used technique for bridging defects in peripheral nerves is the use of autologous nerve grafts. This technique, however, has some disadvantages. Many alternative experimental techniques have thus been developed, such as degradable nerve conduits. Degradable nerve guides have been extensively studied in animal experimental studies. However, the repair of human nerves by degradable nerve conduits has been limited to only a few clinical studies. In this paper, an overview of the available international published literature on degradable nerve conduits for bridging human peripheral nerve defects is presented for literature available until 2004. Also, the philosophy on the use of nerve guides and nerve grafts is given.

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The use of degradable nerve conduits for human nerve repair: A review of the literature

Applied Bionics and Biomechanics ◽

10.1533/abbi.2004.0008 ◽

2005 ◽

Vol 2 (1) ◽

pp. 39-43 ◽

Cited By ~ 1

Author(s):

M. F. Meek ◽

K. Jansen ◽

P. H. Robinson

Keyword(s):

Nerve Repair ◽

Review Of The Literature ◽

Nerve Conduits ◽

Human Nerve

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

The Scientific World JOURNAL ◽

10.1100/2012/413091 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 21

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.

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Recent Advances and Developments in Neural Repair and Regeneration for Hand Surgery

The Open Orthopaedics Journal ◽

10.2174/1874325001206010103 ◽

2012 ◽

Vol 6 (1) ◽

pp. 103-107 ◽

Cited By ~ 19

Author(s):

Mukai Chimutengwende-Gordon ◽

Wasim Khan

Keyword(s):

Gold Standard ◽

Peripheral Nerves ◽

Nerve Repair ◽

Hand Surgery ◽

Matrix Proteins ◽

Neural Repair ◽

Nerve Grafts ◽

Nerve Conduits

End-to-end suture of nerves and autologous nerve grafts are the ‘gold standard’ for repair and reconstruction of peripheral nerves. However, techniques such as sutureless nerve repair with tissue glues, end-to-side nerve repair and allografts exist as alternatives. Biological and synthetic nerve conduits have had some success in early clinical studies on reconstruction of nerve defects in the hand. The effectiveness of nerve regeneration could potentially be increased by using these nerve conduits as scaffolds for delivery of Schwann cells, stem cells, neurotrophic and neurotropic factors or extracellular matrix proteins. There has been extensivein vitroandin vivoresearch conducted on these techniques. The clinical applicability and efficacy of these techniques needs to be investigated fully.

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Material advancement in tissue-engineered nerve conduit

Nanotechnology Reviews ◽

10.1515/ntrev-2021-0028 ◽

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.

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