Peripheral nerve injury, scarring, and recovery

Peripheral nerve injuries (PNI) resulting from trauma can be severe and permanently debilitating. Despite the armamentarium of meticulous microsurgical repair techniques that includes direct repair, grafting of defects with autograft nerve, and grafting with cadaveric allografts, approximately one-t...

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Bibliographic Details
Published in:Connective tissue research 2019-01, Vol.60 (1), p.3-9
Main Authors: Wang, Mark L., Rivlin, Michael, Graham, Jack G., Beredjiklian, Pedro K.
Format: Article
Language:English
Subjects:
Animals
Biomechanical Phenomena
Cicatrix - pathology
Fibrosis
Humans
nerve regeneration
nerve scarring
Peripheral Nerve Injuries - pathology
peripheral nerve injury
Peripheral Nerves - pathology
Peripheral Nerves - physiopathology
transforming growth factor
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Summary:Peripheral nerve injuries (PNI) resulting from trauma can be severe and permanently debilitating. Despite the armamentarium of meticulous microsurgical repair techniques that includes direct repair, grafting of defects with autograft nerve, and grafting with cadaveric allografts, approximately one-third of all PNI demonstrate incomplete recovery with poor restoration of function. This may include total loss or incomplete recovery of motor and/or sensory function, chronic pain, muscle atrophy, and profound weakness, which can result in lifelong morbidity. Much of this impaired nerve healing can be attributed to perineural scarring and fibrosis at the site of injury and repair. To date, this challenging clinical problem has not been adequately addressed. In this review, we summarize the existing literature surrounding biological aspects of perineural fibrosis following PNI, detail current strategies to limit nerve scarring, present our own work developing reliable nerve injury models in animal studies, and discuss potential future studies which may ultimately lead to new therapeutic strategies.
ISSN:0300-8207
1607-8438
DOI:10.1080/03008207.2018.1489381