New York, N.Y. From the Institute of Plastic and Reconstructive Surgery, Department of Surgery, New York University School of Medicine, and the Department of Anatomy/Cell Biology, College of Physicians and Surgeons, Columbia University.
Plast Reconstr Surg. 2009 Dec;124(6 Suppl):e386-e394. doi: 10.1097/PRS.0b013e3181bf8430.
Peripheral nerve defects are common. The surgeon faced with these problems must provide the best functional recovery for the patient with the tools provided. The ideal nerve reconstruction would create a tensionless repair with direct coaptation. However, this is not always possible and other techniques must be employed. The alternatives to direct coaptation include nerve autografts, nerve conduits, and tissue-engineered constructs. This article reviews commonly used autogenous nerve grafts and conduits. Autogenous nerve grafts have been utilized in various techniques which include the trunk graft, cable graft, interfascicular graft, and vascularized graft. The nerve conduits reviewed fall into the category of autogenous biological conduits, nonautogenous biological conduits, and nonbiological conduits. New technologies are being developed to enhance peripheral nerve regeneration with the concept that conduits can be enriched and manipulated in the laboratory to promote regeneration of the peripheral nerve. Further clinical studies hold the promise of successful alternatives for treating peripheral nerve injuries.
周围神经缺损很常见。面对这些问题的外科医生必须为患者提供最佳的功能恢复，而这需要借助现有的工具。理想的神经重建应该是在无张力的情况下直接对接，但这并不总是可行的，因此必须采用其他技术。直接对接的替代方法包括神经自体移植物、神经导管和组织工程构建体。本文综述了常用的自体神经移植物和导管。自体神经移植物已应用于各种技术，包括干移植、电缆移植、束间移植和带血管神经移植。所审查的神经导管属于自体生物导管、非自体生物导管和非生物导管。目前正在开发新技术来增强周围神经再生，其理念是可以在实验室中丰富和操作导管，以促进周围神经的再生。进一步的临床研究有望为治疗周围神经损伤提供成功的替代方法。
