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Open Access 01-10-2020 | Nerve Injury | Original Scientific Report

A New Synthetic Conduit for the Treatment of Peripheral Nerve Injuries

Authors: Selman Uranues, Georg Bretthauer, Gordana Tomasch, Dietmar Rafolt, Doris Nagele-Moser, Andrea Berghold, Reinhold Kleinert, Ivo Justich, Jörg Waldert, Horst Koch

Published in: World Journal of Surgery | Issue 10/2020

Abstract

Background

Peripheral nerve defects (PND) often cause lifelong physical disability, and the available treatment options are often not satisfactory. PND are usually bridged with an autologous nerve transplant or a nerve guidance conduit (NGC), when coaptation as preferred technique is not possible. The aim of this experimental study was to determine the effectiveness of a novel NGC for regeneration in the treatment of PND.

Materials and methods

A conduit made of gelatin with an innovative interior structure was tested for the repair of a 6-mm gap versus direct microsurgical suture repair without gap.

Results

We found that bridging the defect with this conduit was as effective as direct microsurgical coaptation without a defect.

Conclusions

This nerve conduit, effective in bridging neural defects, appears as an alternative to autologous nerve grafts, avoiding the problems related to nerve graft harvesting, host–donor differences in diameter, mismatches in number and pattern of fascicles, cross-sectional shape and area, and morbidity of the donor area.

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Kretschmer Th, Heinen CW, Antoniadis G et al (2009) Iatrogenic nerve injuries. Neurosurg Clin N Am 40:318–321

Ichihara S, Inada Y, Nakamura T (2008) Artificial nerve tubes and their application for repair of peripheral nerve injury: an update of current concepts. Injury 39:29–39CrossRef

Eser F, Aktekin LA, Bodur H et al (2009) Etiological factors of traumatic peripheral nerve injuries. Neurol India 57:434–437CrossRef

Kouyoumdjian JA (2006) Peripheral nerve injuries: a retrospective survey of 456 cases. Muscle Nerve 34:785–788CrossRef

Wee AS, Truitt NR, Smith LD (2006) Type and frequency of peripheral nerve injuries encountered in a clinical neurophysiology laboratory. J Miss State Med Assoc 47:67–71PubMed

Lad SP, Nathan JK, Schubert RD et al (2010) Trends in median, ulnar, radial and brachioplexus nerve injuries in the United States. Neurosurgery 66:953–960CrossRef

Johnson EO, Soucacos PN (2008) Nerve repair: experimental and clinical evaluation of biodegradable artificial nerve guides. Injury 39:30–36CrossRef

Li R, Liu Z, Pan Y et al (2014) Peripheral nerve injuries treatment: a systematic review. Cell Biochem Biophys 68:449–454CrossRef

Millesi H (1985) Peripheral nerve repair: terminology, questions, and facts. J Reconstr Microsurg 2:21–31CrossRef

10.

Johnson PJ, Wood MD, Moore AM et al (2013) Tissue engineered constructs for peripheral nerve surgery. Eur Surg 45:22–135CrossRef

11.

Belkas JS, Shoichet MS, Midha R (2004) Peripheral nerve regeneration through guidance tubes. Neurol Res 26:151–160CrossRef

12.

Mackinnon SE (2011) Technical use of synthetic conduits for nerve repair. J Hand Surg Am 36:183–186CrossRef

13.

Kehoe S, Zhang XF, Boyd D (2012) FDA approved guidance conduits and wraps for peripheral nerve injury: a review of materials and efficacy. Injury 43:553–572CrossRef

14.

Moore AM (2009) Limitations of conduits in peripheral nerve repairs. Hand (NY) 4:180–186CrossRef

15.

Uranüs S, Bretthauer G, Nagele-Moser D et al (2013) New synthetic prosthesis for peripheral nerve injuries: an experimental pilot study. Surg Innov 20:171–175CrossRef

16.

Lahnmüller H, Ashley Z, Unger E et al (2005) Implantable device for long-term electrical stimulation of denervated muscles in rabbits. Med Biol Eng Comput 43:535–540CrossRef

17.

Wolf S, Loose T, Schablowski M et al (2006) Automated feature assessment in instrumented gait analysis. Gait Posture 23:331–338CrossRef

18.

Kuluz J, Samdani A, Benglis D et al (2010) Pediatric spinal cord injury in infant piglets: description of a new large animal model and review of the literature. J Spinal Cord Med Am Parapleg Soc 33:43–57CrossRef

19.

Jonsson S, Wiberg R, McGrath AM et al (2013) Effect of delayed peripheral nerve repair on nerve regeneration, Schwann cell function and target muscle recovery. PLoS ONE 8:e56484CrossRef

20.

Millesi H, Schmidhammer R (2007) End-to-side coaptation-controversial research issue or important tool in human patients. Acta Neurochir 100(Suppl):103–106CrossRef

21.

Gu X, Ding F, Yang Y et al (2011) Construction of tissue engineered nerve grafts and their application in peripheral nerve regeneration. Prog Neurobiol 93:204–230CrossRef

22.

Casañas J, de la Torre J, Soler F et al (2017) Peripheral nerve regeneration after experimental section in ovine radial and tibial nerves using synthetic nerve grafts, including expanded bone marrow mesenchymal cells: morphological and neurophysiological results. Injury 45:2–6CrossRef

Title: A New Synthetic Conduit for the Treatment of Peripheral Nerve Injuries
Authors: Selman Uranues
Georg Bretthauer
Gordana Tomasch
Dietmar Rafolt
Doris Nagele-Moser
Andrea Berghold
Reinhold Kleinert
Ivo Justich
Jörg Waldert
Horst Koch
Publication date: 01-10-2020
Publisher: Springer International Publishing
Keyword: Nerve Injury
Published in: World Journal of Surgery / Issue 10/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-020-05620-0

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

A New Synthetic Conduit for the Treatment of Peripheral Nerve Injuries

Abstract

Background

Materials and methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Materials and methods

Results

Conclusions

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