Nerve repair: Bridging the gap from “limp” to “limb”

Abstract

In some animal studies, it is shown that the tracked fibres terminate at the point of axonal discontinuity within hours after the occurrence of traumatic nerve injury, while the fibres may extend distal to the located injury and show an increase in the fractional anisotropy (FA) in case of nerve regeneration. In addition to installation of allografts that the authors have discussed, there are other biological conduits in use such as autologous veins, arteries, muscles, and heterogeneous collagen tubes (composed of denatured skeletal muscle or muscle basal lamina, veins, and polyglycolic acid (PGA)–collagen tubes). A few synthetic degradable polymers, although being less biocompatible relative to biopolymers, may offer opportunities for a tailored degradation and control of mechanical strength, porosity and microstructural properties. In a nutshell, an autograft is still considered the gold standard, but in the right situations, either conduits or acellular allografts may also achieve equivalent results, making them excellent options for facilitating nerve regeneration.