Synthetic nerve guide implants in humans: a comprehensive survey.
OBJECTIVE
Lesions of the peripheral nervous system result in the loss of sensory and motor function and may in addition be accompanied by severe neuropathic syndromes originating from aberrant axonal regrowth. The transplantation of autologous nerve grafts represents the current "gold standard" during reconstructive surgery, despite obvious side effects. Depending on the demands of the lesion site, various donor nerves may be used for grafting (e.g., the sural, saphenous), sacrificing native functions in their target areas. Recently, several synthetic nerve guide implants have been introduced and approved for clinical use to replace autologous transplants. This alternative therapy is based on pioneering studies with experimental nerve guides.


METHODS
We present a comprehensive review of all published human studies involving synthetic nerve guides.


RESULTS
Data from some 300 patients suggest that for short nerve defects of a few centimeters, resorbable implants provide promising results, whereas a number of late compression syndromes have been documented for nonresorbable implants.


CONCLUSIONS
To treat longer defects, further implant development is needed, a goal that could be achieved, for example, by more closely imitating the intact nerve architecture and regulatory cell-cell interactions.
Schlosshauer
Burkhard
B
Department of Neurobiology, Natural and Medical Sciences Institute, University of Tuebingen, Reutlingen, Germany. schlosshauer@nmi.de
Dreesmann
Lars
L
Schaller
Hans-Eberhard
HE
Sinis
Nektarios
N
D020341:Absorbable Implants; D006801:Humans; D009408:Nerve Compression Syndromes / Q000601:surgery; D009417:Nerve Tissue / Q000637:transplantation; D010523:Peripheral Nervous System Diseases / Q000601:surgery*; D019736:Prostheses and Implants; D014182:Transplantation, Autologous