| Peripheral nerve injuries resulting in extensive loss in nerve continuity pose a challenge in reconstructive surgery. Autografts still remain the treatment of choice for nerve defects despite the need of donor nerve harvest and the associated morbidity of this procedure. In contrast to short gap injuries, isografts achieve sub normal functional recovery for gaps longer than a critical 30 mm length, and simple tubularization methods fail completely. The regenerative failure of peripheral nerves through long gaps can be postulated to the lack of appropriate growth substrate and trophic support. We hypothesize that for successful nerve regeneration across long-gap nerve defects, growth factor support and early vascularization of the regenerated nerve are critical factors. Vascular endothelial growth factor (VEGF) and Pleiotrophin (PTN) have growth promoting effects on neurons as well as the supporting cells, hence suitable for axonal regeneration. Here we described the development of a next generation multi-luminal biodegradable nerve implant repair strategy supplemented with growth factor delivery system, as a construct to bridge the transected neurons across critical peripheral nerve gaps and achieve functional recovery. |
