Analysis of human acellular nerve allograft reconstruction of 64 injured nerves in the hand and upper extremity: a 3 year follow-up study.
Human acellular nerve allografts have been increasingly applied in clinical practice. This study was undertaken to investigate the functional outcomes of nerve allograft reconstruction for nerve defects in the upper extremity. A total of 64 patients from 13 hospitals were available for this follow-up study after nerve repair using human acellular nerve allografts. Sensory and motor recovery was examined according to the international standards for motor and sensory nerve recovery. Subgroup analysis and logistic regression analysis were conducted to identify the relationship between the known factors and the outcomes of nerve repair. Mean follow-up time was 355 ± 158 (35-819) days; mean age was 35 ± 11 (14-68) years; average nerve gap length was 27 ± 13 (10-60) mm; no signs of infection, tissue rejection or extrusion were observed among the patients; 48/64 (75%) repaired nerves experienced meaningful recovery. Univariate analysis showed that site and gap length significantly influenced prognosis after nerve repair using nerve grafts. Delay had a marginally significant relationship with the outcome. A multivariate logistic regression model revealed that gap length was an independent predictor of nerve repair using human acellular nerve allografts. The results indicated that the human acellular nerve allograft facilitated safe and effective nerve reconstruction for nerve gaps 10-60 mm in length in the hand and upper extremity. Factors such as site and gap length had a statistically significant influence on the outcomes of nerve allograft reconstruction. Gap length was an independent predictor of nerve repair using human acellular nerve allografts. Copyright © 2016 John Wiley & Sons, Ltd.
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Shuang
S
Zhu
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Jianghui
J
Liu
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Canbin
C
Zheng
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Liqiang
L
Gu
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Qingtang
Q
Zhu
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Jianping
J
Xiang
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Bo
B
He
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Xiang
X
Zhou
Department of Microsurgery, Orthopedic Trauma and Hand Surgery, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.|Center for Peripheral Nerve Tissue-engineering and Technology Research Guangdong, Guangzhou, People's Republic of China.
Xiaolin
X
Liu
D000293:Adolescent; D000328:Adult; D000368:Aged; D064591:Allografts; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000294:innervation / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D059348:Peripheral Nerve Injuries / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D010525:Peripheral Nerves / Q000637:transplantation*
human acellular nerve allograft; nerve graft; nerve injury; nerve regeneration; peripheral nerve