The Influence of a Predegenerated Autological Nerve Graft on the Results of Peripheral Nerve Repair in the Upper Extremities After Injuries.

Abstract

The improvement in peripheral nerve repair is still challenging, with the process being difficult and frequently unsatisfying. Injuries, even minor ones, can lead to limitations, including the loss of important life functions such as fingers, hands, or all limbs. Our previous research on animals revealed that the distal part of autologous predegenerated nerve grafts, which were injured and left in place for 7 days, was more capable of supporting reconstructed nerve regeneration. Little is known about the efficacy of using predegenerated autologous grafts in humans. Encouraged by promising results in animal models, we decided to investigate this process in humans. A total of 31 patients were evaluated in the study; 19 predegenerated (injured and left in situ for 7 days) autologous sural nerve implants and 12 fresh sural nerve implants were used, and the period of 2 years after operation was chosen as the time of final clinical assessment. Clinical assessment and motor and sensory nerve conduction velocity were assessed. All data were statistically analyzed using stepwise regression testing and a one-way analysis of variance followed by Tukey's test for continuous values and the Mann-Whitney U test for ordinal values. Differences were considered statistically significant for p ≤ 0.05. It turns out that autologous, predegenerated sural nerve grafts used for the reconstruction of traumatic peripheral nerves results in better quantitative and qualitative clinical functional outcomes and more adequate nerve conduction parameters.