Nerve Regeneration

The treatment of injuries to peripheral nerve systems present a lot of difficulties and are one of the biggest surgical challenges. Despite the advancement made by microsurgery and other techniques, the results obtained in peripheral nerve repair has reached a plateau. The efforts of the scientific community are aimed at the use of environmental cues to promote and guide the axon growth with the objective of reconnecting gaps in the peripheral nerve system. Medical devices which aim as nerve guidance and peripheral nerve regeneration are at the center of many research lines. Among the solution presented, the use of natural or synthetic polymers degradable and non-degradable was studied.

Nerve guidance conduits

Nerve guidance conduits should meet some characteristics to allow and promote axonal growth. Permeability is necessary to ensure the presence of nutrients and oxygen before the vascularization of the site. Conduits for nerve regeneration should be flexible in order to prevent damage the surrounding tissue and the growing axon. The choice of the material is of great importance to ensure a proper degradation rate and to prevent inappropriate swelling, avoiding the closure of the channels [S. Kehoe et al., Injury 2010].

Considering the number of characteristic that the scaffolds should meet, electrospun nerve guidance conduits have a great potential in providing what’s necessary to ensure axonal growth and peripheral nerve regeneration. Electrospinning allows to fine tune the features of the scaffolds to the micro- and nanoscale. Several studies showed the possibility reducing the fiber diameter down to the nanoscale as well as to align them, features beneficial for neuronal regeneration. Recent studies showed that conduits based on electrospun synthetic polymers were be able to generate reinnervation of muscle, skin and sweat glands in 15 mm defect in a rat model (Santos et al. Adv Health Mater. 2017). Furthermore, in 2012 Gu et al., described a clinical case study in which a chitosan/polyglycolic acid nerve guidance conduit was utilized to repair a 30 mm long median nerve defect in the right distal forearm of a 55 year-old male patient.

 

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