title: Nerve stepping stone has minimal impact in aiding regeneration across long acellular nerve allografts.
abstract: Acellular nerve allografts (ANAs) yield less consistent favorable outcomes compared with autografts for long gap reconstructions. We evaluated whether a hybrid ANA can improve 6-cm gap reconstruction.
  
  
  
  Rat sciatic nerve was transected and repaired with either 6-cm hybrid or control ANAs. Hybrid ANAs were generated using a 1-cm cellular isograft between 2.5-cm ANAs, whereas control ANAs had no isograft. Outcomes were assessed by graft gene and marker expression (n = 4; at 4 weeks) and motor recovery and nerve histology (n = 10; at 20 weeks).
  
  
  
  Hybrid ANAs modified graft gene and marker expression and promoted modest axon regeneration across the 6-cm defect compared with control ANA (P < 0.05), but yielded no muscle recovery. Control ANAs had no appreciable axon regeneration across the 6-cm defect.
  
  
  
  A hybrid ANA confers minimal motor recovery benefits for regeneration across long gaps. Clinically, the authors will continue to reconstruct long nerve gaps with autografts. Muscle Nerve 57: 260-267, 2018.
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Ying
authors.initials: Y
authors.lastname: Yan
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Hunter
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Lauren
authors.initials: L
authors.lastname: Schellhardt
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Xueping
authors.initials: X
authors.lastname: Ee
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Alison K
authors.initials: AK
authors.lastname: Snyder-Warwick
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Moore
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Mackinnon
authors.affiliation: Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8238, St. Louis, Missouri, 63110, USA.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Wood
mesh_terms: D000375:Aging; D064591:Allografts; D000818:Animals; D001369:Axons / Q000502:physiology; D015415:Biomarkers / Q000032:analysis; D015870:Gene Expression; D005819:Genetic Markers; D008297:Male; D018482:Muscle, Skeletal / Q000254:growth & development / Q000294:innervation; D009416:Nerve Regeneration / Q000502:physiology*; D009474:Neurons / Q000637:transplantation*; D051381:Rats; D011917:Rats, Inbred Lew; D020127:Recovery of Function; D012584:Sciatic Nerve / Q000293:injuries / Q000601:surgery; D013312:Stress, Physiological
chemical_list: D015415:Biomarkers; D005819:Genetic Markers
keywords: acellular nerve allograft; autograft; nerve regeneration; peripheral nerve; senescence