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Topic: Peripheral Nerve Repair and Regeneration

Preface to special issue on "Peripheral

Nerve Repair and Regeneration"

Francesca Toia

Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, Italy.
Address for correspondence: Dr. Francesca Toia, Plastic and Reconstructive Surgery, Department of Surgical, Oncological and Oral Sciences,
University of Palermo, 90127 Palermo, Italy. E-mail: francescatoia@gmail.com

Peripheral nerve surgery has achieved a great improvement recommendations. Three papers of this issue focus on
in the last century. The introduction of microsurgery and different aspects of nerve pain, and suggest promising
the technical advances in reparative and reconstructive directions for research on the mechanism of nerve
techniques has been instrumental in advancing nerve regeneration and nerve guidance (e.g. investigation of
surgery techniques. Yet, in the last few decades, the genetics and biochemical signaling) and novel therapeutic
scientific progress has slowed down significantly, and approaches (e.g. neurostimulation).
surgery is still far from reaching an optimal functional We also reviewed modern advances in surgical techniques
recovery in most cases. for complex nerve injuries, such as vascularized nerve

New surgical approaches are increasingly used for various grafts, which are indicated for long nerve gaps and
indications, but current research mainly focuses on the scarred beds, and nerve transfers, which are indicated for
mechanisms of nerve damage and nerve regeneration. proximal nerve injuries.
It is now clear that nerve regeneration not only relies Free vascularized nerve grafts were first described in the
on surgical reconstruction but also on understanding 1970s. After initial enthusiasm, their popularity decreased
underlying biomolecular processes that could turn out to partly due to their technical difficulty, and only few
be the key for developing novel treatment strategies. surgeons used the technique. Yet, they perform better
With the present special issue on “nerve regeneration than nonvascularized nerve grafts and provide advantage
and repair”, we wish to summarize the state of the art of in recovery in selected cases. Their potential could find
translational and clinical research and present the current a greater expression in the next future, as discussed in a
trends and future prospects in peripheral nerve surgery. review article.
For this purpose, most of the twelve papers in this issue Nerve transfers have opened new horizons in nerve
are review papers. repair strategies: first described in the 19th century, they

This issue begins with an overview of the current have revolutionized the 21th century approach to nerve
neurophysiologic and imaging tests: preoperative injuries, particularly proximal injuries. They are a valuable
diagnostic work‑up and postoperative monitoring, to tool for otherwise unrepairable nerve lesions candidates
provide a clinical guide on the assessment of nerve to palliative treatment (e.g. tendon transfer) and are
injuries. finding increasing indications for repair of both motor
and sensory nerves. Current indications in the upper limb
Then, we discuss nerve pain and dysfunction following nerve injuries are reviewed. Also, two of the papers in this
surgery (e.g. in scar neuropathy or in recalcitrant issue are focused on “sensory protection” and “babysitting
compression neuropathy) and the treatment approaches. procedures”: local nerves can be redirected to a distal
Using current literature, we summarize the analysis of target to prevent the muscle atrophy and the functional
reasons for treatment and the current clinical and surgical
loss that follows prolonged denervation.
To complete the tableau of future prospects in nerve
Access this article online regeneration, two papers of this special issue are focused
Quick Response Code: on two novel fields of research: tissue‑engineered conduits
Website:
www.parjournal.net and robotic‑assisted microsurgery.
Ongoing research holds the potential of revolutionizing
DOI: our approach to nerve repair and regeneration.
10.4103/2347-9264.160876 Tissue‑engineering investigates the potential of different
biomimetic materials as peripheral nerve scaffold, and

Plast Aesthet Res || Vol 2 || Issue 4 || Jul 15, 2015 147