Image: Structure and appearance of the Avance Nerve Graft (Photo courtesy of Axogen).
A new study describes an innovative nerve repair technique that yields better results and fewer side effects than current existing techniques.
Researchers at the University of Kentucky (UKY; Lexington, USA) and the Buncke Clinic (San Francisco, CA) conducted a study to compare 41 subjects with 55 with nerve gap injuries that were repaired with either a nerve allograft (34 subjects), nerve tube conduit (13 subjects), or nerve autograft (8 subjects). Demographics, medical history, and associated injuries were comparable between treatment groups. Response to treatment was defined as improvement from baseline, with independent blind observers determining the degree of sensory or motor recovery.
The results showed that the average nerve gap between the groups varied, at 24±12mm, 11±4 mm, and 57±30mm for processed nerve allograft, conduit, and nerve autograft respectively. Available data reported meaningful levels of recovery in 80% of nerve allografts, as compared to 43% of tube conduits. There were no reported adverse events related to the treatment groups. The study results were presented at the annual combined meeting of the American Association for Hand Surgery, the American Society of Reconstructive Microsurgery, and the American Society of the Peripheral Nerve, held in January 2014 in Kauai (HI, USA).
“The results of the study suggested that nerve allografts had more consistent results and produced better outcomes than nerve conduits, while avoiding the donor site morbidity of a nerve autograft,” said study presenter and coauthor Brian Rinker, MD, Of the UKY Hand Surgery Service. “Nerve grafting has remained relatively unchanged for nearly 100 years, and both of the existing nerve repair options had serious drawbacks. The new technique provides a better, more predictable, and safer nerve gap repair compared to the previous techniques.”
The nerve allograft used in the study was the Avance Nerve Graft, a product of AxoGen (Alachua, FL, USA), and is derived from human nerves harvested from cadavers, which are processed to remove all cellular material, thus preserving their architecture while preventing disease transmission or allergic reactions. Future nerve allografts could be engineered to include growth factors which would guide and promote nerve regeneration, theoretically leading to even faster recoveries and better results.
University of Kentucky