Abstract
To date, reliable data to support the general use of biodegradable materials for bridging nerve defects are still scarce. We present the outcome of nerve regeneration following type I collagen conduit nerve repair in patients with large-diameter nerve gaps. Ten patients underwent nerve repair using a type I collagen nerve conduit. Patients were re-examined at a minimal follow-up of 14.0 months and a mean follow-up of 19.9 months. Regeneration of nerve tissue within the conduits was assessed by nerve conduction velocity (NCV), a static two-point discrimination (S2PD) test, and as disability of arm shoulder and hand (DASH) outcome measure scoring. Quality of life measures including patients’ perceived satisfaction and residual pain were evaluated using a visual analog scale (VAS). No implant-related complications were observed. Seven out of 10 patients reported being free of pain, and the mean VAS was 1.1. The mean DASH score was 17.0. The S2PD was below 6 mm in 40%, between 6 and 10 mm in another 40% and above 10 mm in 20% of the patients. Eight out of 10 patients were satisfied with the procedure and would undergo surgery again. Early treatment correlated with lower DASH score levels. The use of type I collagen in large-diameter gaps in young patients and early treatment presented superior functional outcomes.
Highlights
Advances in microsurgery procedures have brought great progress for the treatment of nerve injuries, the limiting factor for the overall recovery of function remains the unsatisfactory results following nerve restoration [1,2,3]
Numerous recent studies have reported an acceptable clinical outcome regarding sensation with the use of collagen conduits in digital nerve repair [10,19,23,24,25], but few clinical studies exist in the the use of collagen conduits in digital nerve repair [10,19,23,24,25], but few clinical studies exist in the literature reporting tubulization and achievable levels for motor nerve or mixed nerve injuries [8,21]
We report on patients treated with type I collagen nerve conduits in the forearm recovery and patient satisfaction
Summary
Advances in microsurgery procedures have brought great progress for the treatment of nerve injuries, the limiting factor for the overall recovery of function remains the unsatisfactory results following nerve restoration [1,2,3]. Prompt neurorrhaphy performed under minimal tension is the most promising treatment for such lesions [5,6]. Existing nerve gaps following adequate debridement or extensive injuries frequently impede tensionless end-to-end coaptation, and nerve repair under tension seems to be prognostically adverse [5,6]. Autologous nerve grafts, acellular nerve transplants, and nerve guidance conduits are commonly discussed in the context of peripheral nerve gap repair [9,10,11,12]
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