Bridging Gaps in Peripheral Nerves: From Current Strategies to Future Perspectives in Conduit Design.

Publisher: MDPI Country of Publication: Switzerland NLM ID: 101092791 Publication Model: Electronic Cited Medium: Internet ISSN: 1422-0067 (Electronic) Linking ISSN: 14220067 NLM ISO Abbreviation: Int J Mol Sci Subsets: MEDLINE

Original Publication: Basel, Switzerland : MDPI, [2000-

Sciatic Nerve*/injuries ; Peripheral Nerve Injuries*; Animals ; Humans ; Swine ; Polyesters ; Peripheral Nerves/physiology ; Prostheses and Implants ; Polyglycolic Acid ; Nerve Regeneration/physiology

In peripheral nerve injuries (PNI) with substance loss, where tensionless end-to-end suture is not achievable, the positioning of a graft is required. Available options include autografts (e.g., sural nerve, medial and lateral antebrachial cutaneous nerves, superficial branch of the radial nerve), allografts (Avance ^® ; human origin), and hollow nerve conduits. There are eleven commercial hollow conduits approved for clinical, and they consist of devices made of a non-biodegradable synthetic polymer (polyvinyl alcohol), biodegradable synthetic polymers (poly(DL-lactide-ε-caprolactone); polyglycolic acid), and biodegradable natural polymers (collagen type I with/without glycosaminoglycan; chitosan; porcine small intestinal submucosa); different resorption times are available for resorbable guides, ranging from three months to four years. Unfortunately, anatomical/functional nerve regeneration requirements are not satisfied by any of the possible alternatives; to date, focusing on wall and/or inner lumen organization/functionalization seems to be the most promising strategy for next-generation device fabrication. Porous or grooved walls as well as multichannel lumens and luminal fillers are the most intriguing options, eventually also including the addition of cells (Schwann cells, bone marrow-derived, and adipose tissue derived stem cells) to support nerve regeneration. This review aims to describe common alternatives for severe PNI recovery with a highlight of future conduits.

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Keywords: allograft; autograft; hollow nerve conduits; luminal fillers; peripheral nerve injury; wall functionalization

0 (Polyesters)
26009-03-0 (Polyglycolic Acid)

Date Created: 20230610 Date Completed: 20230612 Latest Revision: 20230612

20250114

PMC10252835

10.3390/ijms24119170

37298122