Large Extremity Peripheral Nerve Repair
Abstract
High velocity projectiles and fragments from improvised explosive devices (IED) cause traumatic tissue damage with approximately 20-30% of all extremity injuries and >80% of penetrating injuries being associated with peripheral nerve damage, typically involving large segmental nerve deficits. Standard repair of such injuries uses autologous nerve graft, secured by suture. Outcomes are often unsatisfactory and poor recovery of function adversely affects quality of life and return to active duty. We are investigating a sutureless, light-activated technology for sealing nerve grafts to produce an immediate water-tight seal that protects and optimizes the regenerating nerve environment. Our studies have shown that biocompatible chemical crosslinking of thin amnion and SIS sections considerably strengthens the materials and protects them from rapid biodegradation in vivo that would compromise their function as nerve wrap sealants during the regeneration process. Outcomes of rodent studies of segmental nerve deficit repair using isograft show the best performing wrap/ fixation method to be sutureless photochemical tissue bonding with the crosslinked amnion wrap. This approach will now be taken into final rodent testing with allograft prior to ultimate deployment in a large animal model to transition to human trials.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 2013
- Accession Number
- ADA597791
Entities
People
- Jonathan M. Winograd
- Mark E. Fleming
- Robert W Redmond
Organizations
- Massachusetts General Hospital