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Seminars in Neurosurgery 2001; 12(1): 065-080
DOI: 10.1055/s-2001-13000
Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Synthetic Nerve Conduits: Indications and Technique

Robert A. Weber1 , A. Lee Dellon2
  • 1Division of Plastic Surgery, Scott & White Clinic and Memorial Hospital, Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center College of Medicine, Temple, TX
  • 2Johns Hopkins University School of Medicine, Baltimore, MD.
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Publication History

Publication Date:
31 December 2001 (online)

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ABSTRACT

Synthetic nerve conduits are an important advance in the reconstruction of peripheral nerves. Based on decades of basic science developments showing the potential role of neurotrophic factors in axonal regeneration, conduits create a controlled environment that allows neurites to grow across gaps in an ordered fashion, thereby offering improved function compared to end-to-end repair and significantly less donor site morbidity than nerve grafts. Although vein graft tubes have been used in humans, recently available polyglycolic acid (PGA) conduits are mechanically superior and obviate the need for harvesting autogenous vein. Silicone and Gore-Tex tubes can be used in those cases where a PGA conduit is not available, but they require a second operation for removal. Placement of a conduit is straightforward. The nerve ends are trimmed, a U-stitch is used to draw the nerve ends into the tube, and the remaining space is filled with heparinized saline. Future advances will allow longer gaps to be spanned in a shorter period of time with even better functional results.

KEYWORD

Peripheral nerve - conduit - polyglycolic acid - silicone - Gore-Tex

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