Scientific articleFunctional Outcome Following Nerve Repair in the Upper Extremity Using Processed Nerve Allograft
Section snippets
Study design
We performed this investigation and the RANGER Study registry in accordance with our institutional review boards and Good Clinical Practices.11 All consenting adult subjects implanted with the processed allograft were eligible for the study. We used standardized data capture forms to normalize information from the charts of subjects. Chart reviews were completed in a retrospective fashion to collect subject, injury, and repair demographics as well as outcome measures from surgeon, nursing, and
Results
We conducted an analysis for improvement in nerve function for all subjects based on the last reported follow-up visit. We observed improvement in sensory or motor function in 89% of repairs. There were no reported implant complications, tissue rejections, or adverse events related to the use of the processed nerve allografts. Four injuries (6%) underwent revision. Upon reexploration, 2 subjects had foreign bodies (ie, glass fragments) remaining in the wound bed and 2 subjects reported
Discussion
As an alternative to the classic nerve autograft or hollow tube conduit, nerve allografts provide organized microarchitecture, extracellular matrix constituents, and handling qualities of nerve autograft with the benefit and convenience of an off-the-shelf graft.13, 14 In 1885, Albert15 described nerve gap reconstitution with whole allograft nerve. Although the concept remained attractive, it was hampered by the need to mitigate the patient's immune response.13, 14 The advent of tissue
References (33)
- et al.
Use of decellularized nerve allograft for inferior alveolar nerve reconstruction: a case report
J Oral Maxillofac Surg
(2011) The results of secondary repair of 254 digital nerves
J Hand Surg
(1993)- et al.
Tubular repair of the median or ulnar nerve in the human forearm: a 5-year follow-up
J Hand Surg
(2004) - et al.
A prospective clinical evaluation of biodegradable neurolac nerve guides for sensory nerve repair in the hand
J Hand Surg
(2005) - et al.
A prospective randomized study comparing woven polyglycolic acid and autogenous vein conduits for reconstruction of digital nerve gaps
J Hand Surg
(2011) - et al.
Reconstruction of digital nerves with collagen conduits
J Hand Surg
(2011) - et al.
The results of secondary microsurgical repair of ulnar nerve injury
J Hand Surg
(1993) Nerve injury and repair: regeneration, reconstruction and cortical remodeling
(2005)- et al.
Surgery of the peripheral nerve
(1988) - et al.
Sural nerve donor-site morbidity: thirty-four years of follow-up
Ann Plast Surg
(2006)
Collagen tube conduits in peripheral nerve repair: a retrospective analysis
Hand
The clinical use of artificial nerve conduits for digital nerve repair: a prospective cohort study and literature review
J Reconstr Microsurg
Early clinical outcomes with the use of decellularized nerve allograft for repair of sensory defects within the hand
Hand
Processed allograft: novel use in facial nerve repair after resection of a rare racial nerve paraganglioma
Laryngoscope
Reverse end-to-side nerve transfer: from animal model to clinical use
J Hand Surg
Processed nerve allografts for peripheral nerve reconstruction: a multicenter study of utilization and outcomes in sensory, mixed, and motor nerve reconstructions
Microsurgery
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Supported by AxoGen, Inc., Alachua, Florida.
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.