Peripheral nerve repair throughout the body with processed nerve allografts: Results from a large multicenter study
Open Access
- 26 February 2020
- journal article
- research article
- Published by Wiley in Microsurgery
- Vol. 40 (5), 527-537
- https://doi.org/10.1002/micr.30574
Abstract
Background Peripheral nerve damage resulting in pain, loss of sensation, or motor function may necessitate a reconstruction with a bridging material. The RANGER® Registry was designed to evaluate outcomes following nerve repair with processed nerve allograft (Avance® Nerve Graft; Axogen; Alachua, FL). Here we report on the results from the largest peripheral nerve registry to‐date. Methods This multicenter IRB‐approved registry study collected data from patients repaired with processed nerve allograft (PNA). Sites followed their own standard of care for patient treatment and follow‐up. Data were assessed for meaningful recovery, defined as ≥S3/M3 to remain consistent with previously published results, and comparisons were made to reference literature. Results The study included 385 subjects and 624 nerve repairs. Overall, 82% meaningful recovery (MR) was achieved across sensory, mixed, and motor nerve repairs up to gaps of 70 mm. No related adverse events were reported. There were no significant differences in MR across the nerve type, age, time‐to‐repair, and smoking status subgroups in the upper extremity (p > .05). Significant differences were noted by the mechanism of injury subgroups between complex injures (74%) as compared to lacerations (85%) or neuroma resections (94%) (p = .03) and by gap length between the p = .01). Results were comparable to historical literature for nerve autograft and exceed that of conduit. Conclusions These findings provide clinical evidence to support the continued use of PNA up to 70 mm in sensory, mixed and motor nerve repair throughout the body and across a broad patient population.Keywords
This publication has 37 references indexed in Scilit:
- Innovative Treatment of Peripheral Nerve InjuriesAnnals of Plastic Surgery, 2012
- Processed nerve allografts for peripheral nerve reconstruction: A multicenter study of utilization and outcomes in sensory, mixed, and motor nerve reconstructionsMicrosurgery, 2011
- Experience of using the bioresorbable copolyester poly(DL-lactide-ε-caprolactone) nerve conduit guide Neurolac™ for nerve repair in peripheral nerve defects: Report on a series of 28 lesionsJournal of Hand Surgery (European Volume), 2011
- Sural Nerve Donor-Site MorbidityAnnals of Plastic Surgery, 2006
- Difference in Recovery Potential of Peripheral Nerves after Graft RepairsNeurosurgery, 2006
- Poor results after nerve grafting in the upper extremity: Quo vadis?Microsurgery, 2005
- Results of treatment of the extensive volar wrist lacerations: ???the spaghetti wrist???European Journal of Emergency Medicine, 2002
- A Randomized Prospective Study of Polyglycolic Acid Conduits for Digital Nerve Reconstruction in HumansPlastic and Reconstructive Surgery, 2000
- Clinical utilization and complications of sural nerve biopsyThe American Journal of Surgery, 1993
- An Analysis of the Results of Late Reconstruction of 132 Median NervesJournal of Hand Surgery (European Volume), 1993