Peripheral nerve regeneration

Spontaneous regeneration occurs for nerve gaps that are less than 10 mm; however, injuries that are greater than this length require a graft that will bridge the two nerve ends. Currently, nerve autografts are the "gold standard"; however, their limited availability and efficacy remain a limitation in bridging larger gaps. Therefore, other biological grafts have been investigated, including nerve allografts, veins grafts, artery grafts, and muscle grafts. However, their immunogenicity and inability to match autograft mediated axonal regeneration lead to the development of synthetic nerve conduits. This chapter discusses the relative merits of various "bridging" strategies for peripheral nerve gaps. Synthetic nerve guidance conduits (NGCs) and their fabrication techniques, such as phase separation, solvent casting, electrospinning, and extrusion used to fabricate scaffolds, are explored. In combination with the synthetic NGCs, biochemical augmentation strategies used to mimic the extracellular matrix and growth factor environment within the grafts to encourage axonal regeneration are also discussed.

Duke Scholars

Author Ravi Venkat Bellamkonda Biomedical Engineering