Accession Number : AD1032632


Title :   Large Extremity Peripheral Nerve Repair


Descriptive Note : Technical Report,30 Sep 2012,29 Sep 2016


Corporate Author : Massachusetts General Hospital Boston United States


Personal Author(s) : Redmond,Robert W ; Winograd,Jonathan M ; Fleming,Mark E


Full Text : https://apps.dtic.mil/dtic/tr/fulltext/u2/1032632.pdf


Report Date : 01 Dec 2016


Pagination or Media Count : 93


Abstract : In current war trauma, 20-30% of all extremity injuries and 80% of penetrating injuries being associated with peripheral nerve damage, typically involve large segmental nerve deficits. Standard repair uses autologous nerve graft, secured by suture. Outcomes are unsatisfactory, affecting quality of life and return to active duty. We have investigated a sutureless, light-activated technology for sealing nerve grafts to produce an immediate seal that optimizes the regenerating nerve environment. Our studies have shown that biocompatible chemical crosslinking of human amnion considerably strengthens and protects it from biodegradation in vivo that compromises their function as nerve wrap sealants. 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. Autograft is often unavailable in wounded warriors, due to extensive tissue damage and amputation and, importantly, we also showed nerve regeneration using our approach with an a cellular nerve allograft to be equivalent to standard autograft repair in rodent models. Outcomes have now been validated in a large animal (swine) model with 5 cm ulnar nerve deficit where electrophysiological outcomes for light-activated sealing of a commercial nerve graft conduit (AvanceTM) were equivalent to standard of care autograft.


Descriptors :   peripheral nervous system , wounds and injuries , photochemistry , EXTREMITIES


Subject Categories : Anatomy and Physiology
      Medicine and Medical Research


Distribution Statement : APPROVED FOR PUBLIC RELEASE