UCL Centre for Nanotechnology and Regenerative Medicine, UCL Division of Surgery and Interventional Science, University College London, London, UK.
Biotechnol Appl Biochem. 2011 Sep-Oct;58(5):288-300. doi: 10.1002/bab.51.
Repairing nerve defects with large gaps remains one of the most operative challenges for surgeons. Incomplete recovery from peripheral nerve injuries can produce a diversity of negative outcomes, including numbness, impairment of sensory or motor function, possibility of developing chronic pain, and devastating permanent disability. In the last few years, numerous microsurgical techniques, such as coaptation, nerve autograft, and different biological or polymeric nerve conduits, have been developed to reconstruct a long segment of damaged peripheral nerve. A few of these techniques are promising and have become popular among surgeons. Advancements in the field of tissue engineering have led to development of synthetic nerve conduits as an alternative for the nerve autograft technique, which is the current practice to bridge nerve defects with gaps larger than 30 mm. However, to date, despite significant progress in this field, no material has been found to be an ideal alternative to the nerve autograft. This article briefly reviews major up-to-date published studies using different materials as an alternative to the nerve autograft to bridge peripheral nerve gaps in an attempt to assess their ability to support and enhance nerve regeneration and their prospective drawbacks, and also highlights the promising hope for nerve regeneration with the next generation of nerve conduits, which has been significantly enhanced with the tissue engineering approach, especially with the aid of nanotechnology in development of the three-dimensional scaffold. The goal is to determine potential alternatives for nerve regeneration and repair that are simply and directly applicable in clinical conditions.
用大间隙修复神经缺损仍然是外科医生面临的最具挑战性的手术之一。周围神经损伤不完全恢复会产生多种不良后果,包括麻木、感觉或运动功能障碍、发生慢性疼痛的可能性以及毁灭性的永久性残疾。在过去的几年中,已经开发出许多显微外科技术,如吻合、神经自体移植和不同的生物或聚合物神经导管,以重建受损的长段周围神经。其中一些技术有前途,并在外科医生中流行起来。组织工程领域的进步导致了合成神经导管的发展,作为神经自体移植技术的替代品,神经自体移植技术是目前用于桥接大于 30mm 间隙的神经缺损的方法。然而,迄今为止,尽管该领域取得了重大进展,但尚未发现任何材料可以替代神经自体移植。本文简要回顾了使用不同材料替代神经自体移植来桥接周围神经间隙的主要最新发表的研究,试图评估它们支持和增强神经再生的能力及其潜在的缺点,并强调了下一代神经导管在神经再生方面的有希望的希望,该导管通过组织工程方法得到了显著增强,尤其是在三维支架的开发中借助纳米技术。目标是确定可用于临床的简单直接的神经再生和修复的潜在替代方法。