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

Overview

Journal J Hand Microsurg

Date 2018 Aug 30

PMID 30154617

Citations 20

Authors

Ryan Rebowe

Ashley Rogers

Xuebin Yang

S C Kundu

Thomas L Smith

Zhongyu Li

Affiliations

Soon will be listed here.

Abstract

Nerve 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.

Citing Articles

Engineered bio-functional material-based nerve guide conduits for optic nerve regeneration: a view from the cellular perspective, challenges and the future outlook.

Obeng E, Shen B, Wang W, Xie Z, Zhang W, Li Z Regen Biomater. 2025; 12:rbae133.

PMID: 39776856 PMC: 11703557. DOI: 10.1093/rb/rbae133.

Decellularized Biohybrid Nerve Promotes Motor Axon Projections.

Mehta A, Zhang S, Xie X, Khanna S, Tropp J, Ji X Adv Healthc Mater. 2024; 13(30):e2401875.

PMID: 39219219 PMC: 11616264. DOI: 10.1002/adhm.202401875.

Innervated breast reconstruction: a narrative review of neurotization techniques and outcomes.

Escandon J, Mroueh J, Reid C, Singh D, Sweitzer K, Ciudad P Ann Transl Med. 2024; 12(4):76.

PMID: 39118960 PMC: 11304423. DOI: 10.21037/atm-23-504.

Effects of Physical Cues on Stem Cell-Derived Extracellular Vesicles toward Neuropathy Applications.

Berry D, Ene J, Nathani A, Singh M, Li Y, Zeng C Biomedicines. 2024; 12(3.

PMID: 38540102 PMC: 10968089. DOI: 10.3390/biomedicines12030489.

Graphene-based nanomaterials for peripheral nerve regeneration.

Convertino D, Trincavelli M, Giacomelli C, Marchetti L, Coletti C Front Bioeng Biotechnol. 2024; 11:1306184.

PMID: 38164403 PMC: 10757979. DOI: 10.3389/fbioe.2023.1306184.

References

Sachanandani N, Pothula A, Tung T . Nerve gaps. Plast Reconstr Surg. 2013; 133(2):313-319. DOI: 10.1097/01.prs.0000436856.55398.0f. View

Johnson E, Soucacos P . Nerve repair: experimental and clinical evaluation of biodegradable artificial nerve guides. Injury. 2008; 39 Suppl 3:S30-6. DOI: 10.1016/j.injury.2008.05.018. View

Siemionow M, Brzezicki G . Chapter 8: Current techniques and concepts in peripheral nerve repair. Int Rev Neurobiol. 2009; 87:141-72. DOI: 10.1016/S0074-7742(09)87008-6. View

Sivak W, White J, Bliley J, Tien L, Liao H, Kaplan D . Delivery of chondroitinase ABC and glial cell line-derived neurotrophic factor from silk fibroin conduits enhances peripheral nerve regeneration. J Tissue Eng Regen Med. 2014; 11(3):733-742. DOI: 10.1002/term.1970. View

Bellamkonda R . Peripheral nerve regeneration: an opinion on channels, scaffolds and anisotropy. Biomaterials. 2006; 27(19):3515-8. DOI: 10.1016/j.biomaterials.2006.02.030. View

Lundborg G, Rosen B, Dahlin L, Holmberg J, Rosen I . Tubular repair of the median or ulnar nerve in the human forearm: a 5-year follow-up. J Hand Surg Br. 2004; 29(2):100-7. DOI: 10.1016/j.jhsb.2003.09.018. View

Jenq C, Coggeshall R . Permeable tubes increase the length of the gap that regenerating axons can span. Brain Res. 1987; 408(1-2):239-42. DOI: 10.1016/0006-8993(87)90379-9. View

Bruyns C, Jaquet J, Schreuders T, Kalmijn S, Kuypers P, Hovius S . Predictors for return to work in patients with median and ulnar nerve injuries. J Hand Surg Am. 2003; 28(1):28-34. DOI: 10.1053/jhsu.2003.50026. View

Kehoe S, Zhang X, Boyd D . FDA approved guidance conduits and wraps for peripheral nerve injury: a review of materials and efficacy. Injury. 2011; 43(5):553-72. DOI: 10.1016/j.injury.2010.12.030. View

10.

Lee J, Giusti G, Friedrich P, Archibald S, Kemnitzer J, Patel J . The effect of collagen nerve conduits filled with collagen-glycosaminoglycan matrix on peripheral motor nerve regeneration in a rat model. J Bone Joint Surg Am. 2012; 94(22):2084-91. DOI: 10.2106/JBJS.K.00658. View

11.

de Ruiter G, Spinner R, Yaszemski M, Windebank A, Malessy M . Nerve tubes for peripheral nerve repair. Neurosurg Clin N Am. 2008; 20(1):91-105, vii. DOI: 10.1016/j.nec.2008.08.001. View

12.

Jiang X, Lim S, Mao H, Chew S . Current applications and future perspectives of artificial nerve conduits. Exp Neurol. 2009; 223(1):86-101. DOI: 10.1016/j.expneurol.2009.09.009. View

13.

Gerth D, Tashiro J, Thaller S . Clinical outcomes for Conduits and Scaffolds in peripheral nerve repair. World J Clin Cases. 2015; 3(2):141-7. PMC: 4317607. DOI: 10.12998/wjcc.v3.i2.141. View

14.

de Ruiter G, Malessy M, Yaszemski M, Windebank A, Spinner R . Designing ideal conduits for peripheral nerve repair. Neurosurg Focus. 2009; 26(2):E5. PMC: 2978041. DOI: 10.3171/FOC.2009.26.2.E5. View

15.

Heath C, Rutkowski G . The development of bioartificial nerve grafts for peripheral-nerve regeneration. Trends Biotechnol. 1998; 16(4):163-8. DOI: 10.1016/s0167-7799(97)01165-7. View

16.

Yang Y, Yuan X, Ding F, Yao D, Gu Y, Liu J . Repair of rat sciatic nerve gap by a silk fibroin-based scaffold added with bone marrow mesenchymal stem cells. Tissue Eng Part A. 2011; 17(17-18):2231-44. DOI: 10.1089/ten.TEA.2010.0633. View

17.

Karabekmez F, Duymaz A, Moran S . Early clinical outcomes with the use of decellularized nerve allograft for repair of sensory defects within the hand. Hand (N Y). 2009; 4(3):245-9. PMC: 2724628. DOI: 10.1007/s11552-009-9195-6. View

18.

Sabongi R, Fernandes M, Santos J . Peripheral nerve regeneration with conduits: use of vein tubes. Neural Regen Res. 2015; 10(4):529-33. PMC: 4424734. DOI: 10.4103/1673-5374.155428. View

19.

Sahakyants T, Lee J, Friedrich P, Bishop A, Shin A . Return of motor function after repair of a 3-cm gap in a rabbit peroneal nerve: a comparison of autograft, collagen conduit, and conduit filled with collagen-GAG matrix. J Bone Joint Surg Am. 2013; 95(21):1952-8. DOI: 10.2106/JBJS.M.00215. View

20.

Mackinnon S, Hudson A, Falk R, Kline D, Hunter D . Peripheral nerve allograft: an assessment of regeneration across pretreated nerve allografts. Neurosurgery. 1984; 15(5):690-3. DOI: 10.1227/00006123-198411000-00009. View