title: Regeneration of peripheral nerve gaps with a polyglycolic acid-collagen tube.
abstract: OBJECTIVE
  The aim of this study was to report by means of objective methods on the effectiveness of a nerve reconstruction procedure using a bioresorbable tube in two patients. Our previous successes in regenerating canine peripheral nerves across long distances (80-mm gaps) using a bioabsorbable tube have led us to investigate the value of such a tube for the treatment of human patients with chronic nerve injuries.
  
  
  METHODS
  The device was made from a cylindrically woven polyglycolic acid tube filled with a collagen sponge. It was designed to be resorbed after nerve regeneration. Peripheral sensory nerve defects in two patients with neuroma and pain were reconstructed using this tube. Patient 1 (a 62-year-old man) had a 20-mm defect of the proper digital nerve, and Patient 2 (a 56-year-old woman) had a 65-mm defect of the superficial peroneal nerve.
  
  
  RESULTS
  After surgery, both patients recovered from the unpleasant sensations and intolerable pain. In Patient 1, functional recovery was objectively identified at 2 months, and conduction velocity of the nerve recovered to 49.1 m/s. In Patient 2, conduction velocity of the nerve was determined to be 16.9 m/s at 5 months. Current perception threshold testing indicated that sensory nerve function had been recovered by 65 days after surgery.
  
  
  CONCLUSIONS
  This work represents the first precise clinical evaluation, performed under objective evaluation criteria, of sensory recovery achieved using a nerve tube, suggesting that the use of a polyglycolic acid-collagen tube has the potential to become a viable alternative to conventional autografting for the repair of peripheral nerve defects.
authors.affiliation: Department of Orthopaedic Surgery, Inada Hospital, Nara, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Inada
authors.forename: Shigeru
authors.initials: S
authors.lastname: Morimoto
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Takakura
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Nakamura
mesh_terms: D000200:Action Potentials / Q000502:physiology; D003094:Collagen; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008297:Male; D008866:Microsurgery; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology*; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D010543:Peroneal Nerve / Q000601:surgery; D011100:Polyglycolic Acid; D011183:Postoperative Complications / Q000503:physiopathology; D019919:Prosthesis Implantation; D009435:Synaptic Transmission / Q000502:physiology; D013933:Thumb / Q000294:innervation
chemical_list: D011100:Polyglycolic Acid; D003094:Collagen