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J Reconstr Microsurg 2015; 31(09): 660-667
DOI: 10.1055/s-0035-1558463
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Decellularized Nerves for Upper Limb Nerve Reconstruction: A Systematic Review of Functional Outcomes

Maria Florencia Deslivia
1   Interaction and Robotics Research Center, Korea Institute of Science and Technology, Seoul, Korea
2   Department of HCI and Robotics, University of Science and Technology, Daejeon, Korea
,
Hyun-Joo Lee
3   Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea
,
Arnold Adikrishna
4   Department of Orthopedic Surgery, University of Ulsan, Seoul, Korea
,
In-Ho Jeon
4   Department of Orthopedic Surgery, University of Ulsan, Seoul, Korea
› Author Affiliations
Further Information

Publication History

22 February 2015

10 June 2015

Publication Date:
17 August 2015 (online)

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Abstract

Background This is a systematic review for evaluating the evidence for functional outcomes after decellularized nerve use in clinical setting. Decellularized nerves are allografts whose antigenic components have been removed, leaving only a scaffold that promotes the full regeneration of axons.

Methods Literature research was performed using the PubMed/MEDLINE database for English language studies with the keywords “decellularized nerve” and “processed nerve allograft.” Inclusion criteria were prospective and retrospective case reviews in clinical settings. Exclusion criteria were case reports and case series.

Results We retrieved six level VIII studies and one level VI study (classified according to the Jovell and Navarro–Rubio scale) with a total of 131 reconstructions. The basic data ranges of the studies were as follows: patient age, 18 to 86 years; duration between initial injury and nerve reconstruction procedure, 8 hours to 4 years; and follow-up period, 40 days to 2 years. The maximum lengths of the nerve gap for chemically washed decellularized nerves and cryopreserved decellularized nerves were 50 and 100 mm, respectively. Quantitatively, the functional outcome ranges were as follows: static two-point discrimination, 3 to 5 mm; and moving two-point discrimination, 2 to 15 mm. For motor assessment, all patients had a > M3 Medical Research Council score. It is also important to notice that a large variability occurs in almost every factor in the reviewed studies.

Conclusion Our study is the first to summarize the clinical results of decellularized nerves. Decellularized nerves have been used to bridge nerve gaps ranging from 5 to 100 mm with associated satisfactory outcomes in static and moving two-point discriminations.

Keywords

peripheral nerve - nerve reconstruction - decellularized nerve - processed nerve allograft
 

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