AVAILABLE RECONSTRUCTION METHODS OF NERVE INJURIES – A LITERATURE REVIEW

Vasile Andrei Protesi, "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara, Tudor Alexandru Popoiu, Maria Corina Stanciulescu, Petrisor Zorin Crainiceanu, Vlad-Adam Bloanca, Calin Marius Popoiu, "Victor Babes" University of Medicine and Pharmacy, Timisoara, "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara, "Victor Babes" University of Medicine and Pharmacy, Timisoara, "Victor Babes" University of Medicine and Pharmacy, Timisoara, "Louis Turcanu" Clinical Emergency Hospital for Children, Timisoara (+4 others)
2020 Jurnalul pediatrului  
Nerve reconstructive methods include in addition to surgical technique also a close postoperative follow up and a good understanding of nerve regeneration. Direct reconstruction involves the neurorrhaphy of the nerve stumps if they have a proper vascularization and the suture can be done without tension. There are several suturing techniques like end-to-end, end-to-side and side-to-side coaptation. End-to-end neurorrhaphy is the procedure of choice, due to a higher axonal regeneration and
more » ... outcomes. When the surgeon faces a major injury with an extensive nerve loss, the reconstruction is made using nerve grafts. The autologous graft has superior results compared to the non-autologous grafts. It has the benefit of being an immunologically inert structure, contains Schwann cells, neutrophic factors and adhesion molecules that help the nerve to regenerate better. Currently the researchers concentrate on the development of a synthetic material that will successfully replace the autologous graft. The substituents are represented by nerve ducts or conduits and cadaveric allografts, which have the advantage of adequate microarchitecture and neurotrophic factors beneficial to axonal regrowth, but require up to 2 years of immunosuppressive therapy. This branch is in a continuous progress, and maybe in the future the patients will benefit from a close-to-ideal synthetic nerve graft to replace the available grafts. Another technique is the nerve transfer that involves the use of a distal nerve branch anastomosed with the injured nerve near the neuromuscular junction in order to transmit a nerve impulse and thus the muscle to resume its function. The results of nerve transfer are promising, being an adjuvant method for patients with unsatisfactory initial results.
doi:10.37224/jp.2020.8990.05 fatcat:ppnvp65qdrdbrhlcyzxnf73oya