Nerve grafts and conduits.
Peripheral nerve defects are common. The surgeon faced with these problems must provide the best functional recovery for the patient with the tools provided. The ideal nerve reconstruction would create a tensionless repair with direct coaptation. However, this is not always possible and other techniques must be employed. The alternatives to direct coaptation include nerve autografts, nerve conduits, and tissue-engineered constructs. This article reviews commonly used autogenous nerve grafts and conduits. Autogenous nerve grafts have been utilized in various techniques which include the trunk graft, cable graft, interfascicular graft, and vascularized graft. The nerve conduits reviewed fall into the category of autogenous biological conduits, nonautogenous biological conduits, and nonbiological conduits. New technologies are being developed to enhance peripheral nerve regeneration with the concept that conduits can be enriched and manipulated in the laboratory to promote regeneration of the peripheral nerve. Further clinical studies hold the promise of successful alternatives for treating peripheral nerve injuries.
Colen
Kari L
KL
New York, N.Y. From the Institute of Plastic and Reconstructive Surgery, Department of Surgery, New York University School of Medicine, and the Department of Anatomy/Cell Biology, College of Physicians and Surgeons, Columbia University.
Choi
Mihye
M
Chiu
David T W
DTW
D000714:Anastomosis, Surgical / Q000379:methods; D006801:Humans; D010525:Peripheral Nerves / Q000033:anatomy & histology / Q000601:surgery* / Q000637:transplantation*; D019736:Prostheses and Implants; D023822:Tissue Engineering; D014182:Transplantation, Autologous