[The mechanisms of the regulation of axonal growth and orientation at the border between theory and practice].
After a period of fast developing, the current philosophy of the microneurosurgical management of the peripheral nerve injury has to overcome new frontiers. The operating microscopes have almost reached the ultimate limit of perfection, the atraumatic needles are at the edge of maneuverability, the instruments are day by day more refined end more expensive, and the surgeons have reached the limit of human technique refinement. More and more experienced operators are convinced that, based on current clinical concepts and techniques, new spectacular functional results in nerve regeneration after nerve repair are not expected. They all agree that even direct neurography is considered the first choice,in cases with nerve defect and gap the nerve graft (even vascularized) is not an acceptable solution. It seems that the mesothelial chamber, silicone and absorbable nerve conduits, neurotrophic and neurotropic factors are opening new directions în reconstructive microneurosurgery. However the meaningful step outside the experimental laboratory into the clinical routine is still to be expected. An up-to-date review of the possibilities we may have is helpful for those willing to combine their clinical activity with experimental research in order to improve the long term functional outcome of their patients.
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Clinica de Chirurgie Plastică şi Reconstructivă, Facultatea de Medicină, Universitatea de Medicina şi Farmacie Gr. T. Popa, Iaşi.
D000818:Animals; D001158:Arteries / Q000294:innervation; D001369:Axons / Q000502:physiology*; D002633:Chemotaxis / Q000502:physiology; D004574:Electromagnetic Fields; D006801:Humans; D018482:Muscle, Skeletal / Q000294:innervation; D009414:Nerve Growth Factors / Q000494:pharmacology / Q000502:physiology; D014680:Veins / Q000294:innervation
D009414:Nerve Growth Factors