Processed nerve allografts for peripheral nerve reconstruction: A multicenter study of utilization and outcomes in sensory, mixed, and motor nerve reconstructions
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- 28 November 2011
- journal article
- research article
- Published by Wiley in Microsurgery
- Vol. 32 (1), 1-14
- https://doi.org/10.1002/micr.20975
Abstract
Purpose: As alternatives to autograft become more conventional, clinical outcomes data on their effectiveness in restoring meaningful function is essential. In this study we report on the outcomes from a multicenter study on processed nerve allografts (Avance® Nerve Graft, AxoGen, Inc). Patients and Methods: Twelve sites with 25 surgeons contributed data from 132 individual nerve injuries. Data was analyzed to determine the safety and efficacy of the nerve allograft. Sufficient data for efficacy analysis were reported in 76 injuries (49 sensory, 18 mixed, and 9 motor nerves). The mean age was 41 ± 17 (18–86) years. The mean graft length was 22 ± 11 (5–50) mm. Subgroup analysis was performed to determine the relationship to factors known to influence outcomes of nerve repair such as nerve type, gap length, patient age, time to repair, age of injury, and mechanism of injury. Results: Meaningful recovery was reported in 87% of the repairs reporting quantitative data. Subgroup analysis demonstrated consistency, showing no significant differences with regard to recovery outcomes between the groups (P > 0.05 Fisher's Exact Test). No graft related adverse experiences were reported and a 5% revision rate was observed. Conclusion: Processed nerve allografts performed well and were found to be safe and effective in sensory, mixed and motor nerve defects between 5 and 50 mm. The outcomes for safety and meaningful recovery observed in this study compare favorably to those reported in the literature for nerve autograft and are higher than those reported for nerve conduits. © 2011 Wiley Periodicals, Inc. Microsurgery, 2012.Keywords
This publication has 38 references indexed in Scilit:
- Nerve Endoneurial Microstructure Facilitates Uniform Distribution of Regenerative Fibers: A Post Hoc Comparison of Midgraft Nerve Fiber DensitiesJournal of Reconstructive Microsurgery, 2010
- Treatment of Acute Peripheral Nerve Injuries: Current ConceptsThe Journal of Hand Surgery, 2010
- Collagen Tube Conduits in Peripheral Nerve Repair: A Retrospective AnalysisHAND, 2009
- UPPER-EXTREMITY PERIPHERAL NERVE INJURIESNeurosurgery, 2009
- The Economic Impact of Electric Saw Injuries to the HandThe Journal of Hand Surgery, 2009
- Early Clinical Outcomes with the Use of Decellularized Nerve Allograft for Repair of Sensory Defects within the HandHAND, 2009
- Incidence of Traumatic Peripheral Nerve Injuries and Amputations in Sweden between 1998 and 2006Neuroepidemiology, 2009
- Chondroitinase treatment increases the effective length of acellular nerve graftsExperimental Neurology, 2007
- Surgical treatment and outcomes in 15 patients with anterior interosseous nerve entrapments and injuriesJournal of Neurosurgery, 2006
- The Results of Secondary Repair of 254 Digital NervesJournal of Hand Surgery (European Volume), 1993