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Tissue Engineering pp 245–262Cite as

Tissue Engineering for Peripheral Nerve Regeneration

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Abstract

The outcome of peripheral nerve repair has changed very little over the past 50 years, and clinical outcomes remain generally poor. Surgical technique has evolved to a high level of technical microsurgical proficiency, but this approach remains unable to adequately address the neurobiological barriers to the optimization of nerve regeneration. Reconstruction of complex segmental injuries, as in the brachial plexus, additionally requires a considerable length of interpositional nerve autograft, which may be unobtainable without considerable donor morbidity.

Research has therefore turned to the modulation of the repair-site environment to optimise nerve regeneration across neurorraphies, and to the creation of nerve conduits to reduce the need for nerve autograft. Tissue engineering has involved the use of growth factors to modulate neuronal and glial cell behaviour, and the creation of macro, micro and nanoscale constructs from a variety of materials in order to replace the connective tissue functions of nerve autograft. Implantation of cultured Schwann and stem cells is an area of particular development given the necessity of viable support cells to facilitate neuronal growth. These approaches are reviewed in the light of current published work.

The future of peripheral nerve repair lies in the modulation of neuronal and glial cell responses to nerve injury, and during regeneration, while taking account of the clinical requirements and practical limitations. The peripheral nervous system also provides a simpler model for nerve regeneration than the central nervous system, but with translational potential.

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Authors and Affiliations

  1. Canniesburn Plastic Surgery Unit and Scottish National Brachial Plexus Service, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK

    Andrew Hart

  2. Centre for Cell Engineering, The University of Glasgow, Hillhead, Glasgow, UK

    Andrew Hart

  3. Department of Surgical and Perioperative Science, Section for Hand and Plastic Surgery, University Hospital, Umeå, Sweden

    Andrew Hart & Mikael Wiberg

  4. Department of Integrative Medical Biology, Section for Anatomy, Umeå University, SE-901 87, Umeå, Sweden

    Andrew Hart & Mikael Wiberg

  5. Blond-McIndoe Research Laboratories, Plastic and Reconstructive Surgery Research, The University of Manchester, Stopford Building, Oxford Road, Manchester, M13 9PT, UK

    Giorgio Terenghi

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  1. Klinik für Plastische Chirurgie,, Hand- und Verbrennungschirurgie, Universitätsklinikum Aachen, Pauwelsstr. 30, Aachen, 52057, Germany

    Norbert Pallua

  2. Klinik für Plastische Chirurgie,, Hand- und Verbrennungschirurgie, Universitätsklinikum Aachen, Pauwelsstr. 30, Aachen, 52057, Germany

    Christoph V. Suscheck

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Hart, A., Terenghi, G., Wiberg, M. (2011). Tissue Engineering for Peripheral Nerve Regeneration. In: Pallua, N., Suscheck, C. (eds) Tissue Engineering. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-02824-3_13

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