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Seminars in Neurosurgery 2001; 12(1): 093-099
DOI: 10.1055/s-2001-13002
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Antiadhesion Barrier Gels in Peripheral Nerve Surgery

Emanuel A. Palatinsky
  • Gliatech Inc., Cleveland, OH.
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Reconstructive procedures on peripheral nerves have benefited from many recent advances. Unfortunately, compression syndromes caused by postoperative scar adversely affect a significant number of patients even after an impeccable surgical repair. Scar tissue still represents a formidable impediment to new nerve regeneration, and its long-term effects may cause irreversible neurologic damage and unremitting pain. Conservative therapy has little to offer, whereas secondary surgery is afflicted by frequent recurrences. Because the formation of symptomatic scar is unpredictable, its prophylaxis can only be achieved through a multidisciplinary approach, which includes meticulous surgical technique and the use of new biomaterials. Notwithstanding the intensive biotechnologic quest toward safe and effective adhesion barriers, their use and acceptance remains to be established. Prevention of perineural scar is discussed in relation to the pathogenetic mechanisms of peripheral nerve adhesion and compression syndromes. The requirements for an adequate adhesion barrier are proposed, and current experience with novel antiadhesion devices is reviewed.

KEYWORD

Peripheral nerves - postoperative adhesions - antiadhesion gel - scar tissue

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