Bridging the Gap

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Science  16 May 2008:
Vol. 320, Issue 5878, pp. 851
DOI: 10.1126/science.320.5878.851b

Peripheral nerves can be severed by injury or surgical procedures. For large gaps, the only clinical route to repair is through the use of autografts. However, this option requires a second surgical procedure with potential complications at the donor site and there is a limit on the number of suitable donor sites, as only motor or mixed nerves make suitable donors, whereas purely sensory nerves do not. Kim et al. fabricated films of an electrospun polymer, with either aligned or randomly distributed fibers that were stacked into thicker constructs. Studies were conducted on rats with 17-mm nerve gaps using both constructs, as well as autografts and saline injections as controls. The polymer films with randomly oriented fibers showed poor axon growth. In contrast, the aligned fibers helped facilitate nerve regeneration with the propagation of Schwann cells from both nerve stumps. Axons were found to grow from the proximal stump, but only in places where the Schwann cells had migrated. The aligned constructs were almost as effective as the autografts in restoring muscle functionality, but the pattern of nerve regeneration differed between those grown on the polymer and the autografts or normal nerves, and there was greater electrical signal latency. Overall, the work shows that topography of a graft, without the addition of neurotrophic factors or cell transplants, may be enough to induce nerve regeneration. — MSL

Biomaterials 29, 10.1016/j.biomaterials.2008.03.042 (2008).

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