A retrospective case series reporting the outcomes of Avance nerve allografts in the treatment of peripheral nerve injuries.

Leckenby, Jonathan; Furrer, Curdin; Haug, Luzian; Juon Personeni, Bettina; Vögelin, Esther (2019). A retrospective case series reporting the outcomes of Avance nerve allografts in the treatment of peripheral nerve injuries. (In Press). Plastic and reconstructive surgery Wolters Kluwer 10.1097/PRS.0000000000006485

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INTRODUCTION Acellular nerve allografts are viable treatment modality for bridging nerve gaps. Several small studies have demonstrated equal results to autologous grafts, however there is lacking information regarding outcomes for wider indications. The aim of this retrospective case series was to evaluate the outcomes of patients treated with a nerve allograft in a variety of clinical situations. METHODS A retrospective chart analysis was completed between April 2009 - October 2017. The inclusion criteria for this study were: age ≥ 18 years at the time of surgery and be treated with a nerve allograft. Patients were excluded if they had not been followed-up for a minimum of six months. The modified Medical Research Council Classification (MRCC) was used to monitor motor and sensory changes in the post-operative period. RESULTS 207 nerve allografts were used in 156 patients; of these 129 patients with 171 nerve allografts fulfilled the inclusion criteria. 77% of patients achieved a sensory outcome score of S3 or above and 36% achieved a motor score of M3 or above. All patients with chronic pain had improvement of their symptoms. DISCUSSION Graft length and diameter were negatively correlated with reported outcomes. One patient elected to undergo revisional surgery and the original graft was shown histologically to have extensive central necrosis. Anatomically, allografts used for lower limb reconstruction yielded the poorest results. All chronic patients had a significantly lower post-operative requirement for analgesia and allografts are effective in not only reducing pain, but also restoring a functional level of sensation. CONCLUSION This study supports the wider application of allografts in managing nerve problems however caution must be applied to the use of long grafts with larger diameters.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Plastic, Reconstructive and Aesthetic Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery > Hand Surgery
04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Plastic and Hand Surgery

UniBE Contributor:

Leckenby, Jonathan Ian; Haug, Luzian Carlo Peter; Juon, Bettina and Vögelin, Esther

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1529-4242

Publisher:

Wolters Kluwer

Language:

English

Submitter:

Veronika Picha

Date Deposited:

06 Jan 2020 15:54

Last Modified:

06 Jan 2020 15:54

Publisher DOI:

10.1097/PRS.0000000000006485

PubMed ID:

31842129

BORIS DOI:

10.7892/boris.136965

URI:

https://boris.unibe.ch/id/eprint/136965

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