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      Past, Present, and Future of Nerve Conduits in the Treatment of Peripheral Nerve Injury

      review-article
      Author(s): 1 , 2 , 3 , 3 , *
      Publication date (Electronic):
      Journal: BioMed Research International
      Publisher: Hindawi Publishing Corporation

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          Abstract

          With significant advances in the research and application of nerve conduits, they have been used to repair peripheral nerve injury for several decades. Nerve conduits range from biological tubes to synthetic tubes, and from nondegradable tubes to biodegradable tubes. Researchers have explored hollow tubes, tubes filled with scaffolds containing neurotrophic factors, and those seeded with Schwann cells or stem cells. The therapeutic effect of nerve conduits is improving with increasing choice of conduit material, new construction of conduits, and the inclusion of neurotrophic factors and support cells in the conduits. Improvements in functional outcomes are expected when these are optimized for use in clinical practice.

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          Peripheral Nerve Reconstruction after Injury: A Review of Clinical and Experimental Therapies

          D. Grinsell, C. P. Keating (2014)
          Unlike other tissues in the body, peripheral nerve regeneration is slow and usually incomplete. Less than half of patients who undergo nerve repair after injury regain good to excellent motor or sensory function and current surgical techniques are similar to those described by Sunderland more than 60 years ago. Our increasing knowledge about nerve physiology and regeneration far outweighs our surgical abilities to reconstruct damaged nerves and successfully regenerate motor and sensory function. It is technically possible to reconstruct nerves at the fascicular level but not at the level of individual axons. Recent surgical options including nerve transfers demonstrate promise in improving outcomes for proximal nerve injuries and experimental molecular and bioengineering strategies are being developed to overcome biological roadblocks limiting patient recovery.
          Article 0 comments Cited 285 times – based on 0 reviews     Review now
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            A biomaterials approach to peripheral nerve regeneration: bridging the peripheral nerve gap and enhancing functional recovery.

            Sagar Pandit, L. Yao, A Windebank … (2012)
            Microsurgical techniques for the treatment of large peripheral nerve injuries (such as the gold standard autograft) and its main clinically approved alternative--hollow nerve guidance conduits (NGCs)--have a number of limitations that need to be addressed. NGCs, in particular, are limited to treating a relatively short nerve gap (4 cm in length) and are often associated with poor functional recovery. Recent advances in biomaterials and tissue engineering approaches are seeking to overcome the limitations associated with these treatment methods. This review critically discusses the advances in biomaterial-based NGCs, their limitations and where future improvements may be required. Recent developments include the incorporation of topographical guidance features and/or intraluminal structures, which attempt to guide Schwann cell (SC) migration and axonal regrowth towards their distal targets. The use of such strategies requires consideration of the size and distribution of these topographical features, as well as a suitable surface for cell-material interactions. Likewise, cellular and molecular-based therapies are being considered for the creation of a more conductive nerve microenvironment. For example, hurdles associated with the short half-lives and low stability of molecular therapies are being surmounted through the use of controlled delivery systems. Similarly, cells (SCs, stem cells and genetically modified cells) are being delivered with biomaterial matrices in attempts to control their dispersion and to facilitate their incorporation within the host regeneration process. Despite recent advances in peripheral nerve repair, there are a number of key factors that need to be considered in order for these new technologies to reach the clinic.
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              From lactic acid to poly(lactic acid) (PLA): characterization and analysis of PLA and its precursors.

              Saara Inkinen, Minna Hakkarainen, Ann-Christine Albertsson … (2011)
              The quality of the monomers lactic acid and lactide as well as the chemical changes induced during polymerization and processing are crucial parameters for controlling the properties of the resulting poly(lactic acid) (PLA) products. This review presents the most important analysis and characterization methods for quality assessment of PLA and its precursors. The impurities typically present in lactic acid or lactide monomers and their possible origins and effects on resulting PLA products are discussed. The significance of the analyses for the different polymer production stages is considered, and special applications of the methods for studying features specific for PLA-based materials are highlighted.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Biomed Res Int
                Journal ID (iso-abbrev): Biomed Res Int
                Journal ID (publisher-id): BMRI
                Title: BioMed Research International
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 2314-6133
                ISSN (Electronic): 2314-6141
                Publication date (Print): 2015
                Publication date (Electronic): 27 September 2015
                Volume: 2015
                Electronic Location Identifier: 237507
                Affiliations
                1Medical Center, Tsinghua University, Beijing 8610084, China
                2Department of Orthopedics, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang 86838010, China
                3Institute of Tissue Engineering, China Medical University, No. 77 Puhe Road, Shenyang North New Area, Shenyang, Liaoning 86110122, China
                Author notes

                Academic Editor: Aijun Wang

                Article
                DOI: 10.1155/2015/237507
                PMC ID: 4600484
                PubMed ID: 26491662
                SO-VID: cf9121bf-af2d-4d8e-a45f-2111ab772ac4
                Copyright © Copyright © 2015 A. Muheremu and Q. Ao.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 12 February 2015
                Date revision received : 12 May 2015
                Date accepted : 19 May 2015
                Categories
                Subject: Review Article

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