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Topic: Peripheral Nerve Repair and Regeneration

Tissue-engineered constructs for peripheral

nerve repair: current research concepts and

future perspectives

Alba C. de Luca , Wassim Raffoul , Francesco Giacalone , Maddalena Bertolini ,
3
3
1
2
Pietro G. di Summa 2,3
1 EPFL, Centre for Neuroprosthetics, Laboratory for Soft Bioelectronic Interfaces, 1015 Lausanne, Switzerland.
2 Department of Plastic, Reconstructive and Hand Surgery, University Hospital of Lausanne (Centre Hospitalier Universitaire Vaudois),
1011 Lausanne, Switzerland.
3 Department of Hand Surgery and Microsurgery, CTO‑Maria Adelaide Trauma Center, 10126 Torino, Italy.
Address for correspondence: Dr. Pietro G. di Summa, Department of Plastic, Reconstructive and Hand Surgery, University Hospital of
Lausanne (Centre Hospitalier Universitaire Vaudois), 1011 Lausanne, Switzerland. E-mail: pietro.di-summa@chuv.ch

ABSTRACT
Traumatic injuries resulting in peripheral nerve lesions lead to important morbidity with devastating
social and economic consequences. When the lesioned nerve cannot be sutured directly, a nerve graft
is generally required to bridge the gap. Although autologous nerve grafting is still the first choice for
reconstruction, it has the severe disadvantage of the sacrifice of a functional nerve. Research in tissue
engineering and nerve regeneration may have a dramatic impact on clinical and surgical treatment of
such nerve lesions. The authors review the latest concepts in tissue engineering for nerve repair, including
scaffold engineering of neural guides, biomaterial modification, cell therapy, growth factors delivery,
and electrical stimulation. Recent literature is reviewed in detail, pointing out the most interesting
present achievements and perspectives for future clinical translation. Electronic search of the literature
was performed using MEDLINE, Embase, and the Cochrane Library to identify research studies on
peripheral nerve regeneration through tissue-engineered conduits. The following medical subject
headings were used to carry out a systematic search of the literature: “nerve regeneration”, “stem cells”,
“biomaterial”, “extracellular matrix”, “functional regeneration”, “growth factors” and “microchannels”.
Included literature was published between 1991 and 2014. The reference lists from the retrieved articles
were also reviewed for additional articles. In total, 76 articles were included in this study.
Key words:
Cell transplantation, extracellular matrix, growth factors, nerve guidance conduit, peripheral nerve
repair, surface modification

INTRODUCTION and injury recovery can occur without surgery. However,
severe trauma can cause the complete disruption of the
The success of repair after peripheral nerve injury nerve (neurotmesis), resulting in the complete loss of
depends on the type and the extension of the trauma. continuity and function. [1]
In the event of nerve compression or sheath loss, the The two segments generated after nerve transection
structural elements in the nerve tissue are preserved,
retract, and edema occurs at the distal stump. The latter
starts to swell and degenerates within hours in a process
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[2]
known as “Wallerian degeneration”. The regeneration
Quick Response Code: process takes place at the proximal stump, where the
Website:
www.parjournal.net axon soma is still included, forming the growth cone that
expands toward the distal stump to bridge the gap.
DOI: When nerves are severed, and denervation occurs, the
10.4103/2347-9264.160889 longer the lag time reinnervation, the worse the functional
recovery. Long denervation time, as clinically seen in
[3]
Plast Aesthet Res || Vol 2 || Issue 4 || Jul 15, 2015 213