Radecka Weronika, Nogalska Wiktoria, Siemionow Maria
Department of Orthopaedics, University of Illinois at Chicago, Chicago, IL 60607, USA.
Department of Anatomy, Institute of Medical Sciences, University of Opole, 45040 Opole, Poland.
J Funct Biomater. 2025 Apr 24;16(5):153. doi: 10.3390/jfb16050153.
Peripheral nerve injuries (PNIs) are a significant clinical challenge, often resulting in persistent sensory and motor deficits despite surgical repair. Autologous nerve grafts remain the gold standard for repair; however, outcomes are frequently suboptimal due to donor site morbidity and inconsistent functional recovery. A major obstacle in nerve regeneration is the formation of postoperative adhesions and fibrosis, which impede healing and necessitate revision surgeries. Nerve protectors from biological, synthetic, and hybrid materials offer a promising tissue engineering strategy to enhance nerve regeneration. These protectors are applied as a protective barrier when a nerve is severed without the gap, allowing for direct repair. They provide mechanical support and reduce scarring. Biocompatible biological wraps, including vascularized fat flaps, vein wraps, collagen-based materials, human amniotic membrane (hAM), porcine small intestinal submucosa (PSIS), and chitosan, modulate immune responses and promote vascularization. Synthetic alternatives, like polycaprolactone (PCL), provide mechanical stability with controlled degradation. Hybrid wraps, such as PCL-amnion, combine the benefits of both. Despite optimistic results, the heterogeneity of study methodologies hinders direct comparisons and standardization. This review highlights the latest developments in nerve wraps, their clinical applications, limitations, and future potential, guiding clinicians in selecting the most appropriate materials for peripheral nerve repair.
周围神经损伤（PNIs）是一项重大的临床挑战，尽管进行了手术修复，仍常常导致持续的感觉和运动功能障碍。自体神经移植仍然是修复的金标准；然而，由于供体部位的并发症和功能恢复不一致，结果往往不尽人意。神经再生的一个主要障碍是术后粘连和纤维化的形成，这会阻碍愈合并需要进行翻修手术。来自生物、合成和混合材料的神经保护剂提供了一种有前景的组织工程策略来促进神经再生。当神经在无间隙的情况下被切断时，这些保护剂被用作保护屏障，以便进行直接修复。它们提供机械支撑并减少瘢痕形成。生物相容性生物包裹物，包括带血管的脂肪瓣、静脉包裹物、胶原基材料、人羊膜（hAM）、猪小肠黏膜下层（PSIS）和壳聚糖，可调节免疫反应并促进血管生成。合成替代品，如聚己内酯（PCL），提供具有可控降解性的机械稳定性。混合包裹物，如PCL-羊膜，结合了两者的优点。尽管结果令人乐观，但研究方法的异质性阻碍了直接比较和标准化。本综述强调了神经包裹物的最新进展、它们的临床应用、局限性和未来潜力，指导临床医生选择最合适的材料用于周围神经修复。
