Chapter 57 - Nerve Regeneration and Bioengineering

Abstract

Achieving complete functional recovery from peripheral nerve (PN) damage remains a major challenge for plastic surgeons. Nerve autografting is the current “gold standard” technique to bridge large diameter nerves with gap size greater than 30mm. Advancements in the field of biomaterial science and tissue engineering have led to the development of synthetic nerve conduits. These conduits overcome the major limitations associated with autografting technique including donor site morbidity and lack of suitable graft material. The available Food and Drug Administration (FDA) and Conformité Européenne (CE)-approved nerve conduits for PN repair are either natural based (collagen and decellularized allograft) or synthetic (polyester)-based conduits. These commercially available nerve conduits have shown promising results on repairing short defects. However, so far, no ideal biomaterial and design has been found to be a perfect substitution to nerve autografting for bridging large gaps (>30mm). This chapter briefly reviews currently available surgical options for restoring nerve functionality. Furthermore, it will highlight the promising hopes held by tissue engineering to develop the next generation of nerve conduits. The ultimate goal is to determine potential alternatives for nerve regeneration which are simply applicable for clinical cases.