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Titolo:
A randomized prospective study of polyglycolic acid conduits for digital nerve reconstruction in humans
Autore:
Weber, RA; Breidenbach, WC; Brown, RE; Jabaley, ME; Mass, DP;
Indirizzi:
Scott & White Mem Hosp & Clin, Dept Surg, Div Plast Surg, Scott Sherwood &Brindley Fdn, Temple, TX 76508 USA Scott & White Mem Hosp & Clin Temple TXUSA 76508 n, Temple, TX 76508 USA Texas A&M Univ Syst, Hlth Sci Ctr, Coll Med, Temple, TX 76508 USA Texas A&M Univ Syst Temple TX USA 76508 r, Coll Med, Temple, TX 76508 USA Kleinert Kutz & Associates, Hand Care Ctr, Springfield, IL USA Kleinert Kutz & Associates Springfield IL USA e Ctr, Springfield, IL USA So Illinois Univ, Dept Plast Surg, Springfield, IL USA So Illinois Univ Springfield IL USA Dept Plast Surg, Springfield, IL USA Springfield Clin, Springfield, IL USA Springfield Clin Springfield IL USA pringfield Clin, Springfield, IL USA Univ Chicago, Dept Surg, Sect Orthopaed Surg & Rehabil Med, Chicago, IL 60637 USA Univ Chicago Chicago IL USA 60637 rg & Rehabil Med, Chicago, IL 60637 USA
Titolo Testata:
PLASTIC AND RECONSTRUCTIVE SURGERY
fascicolo: 5, volume: 106, anno: 2000,
pagine: 1036 - 1045
SICI:
0032-1052(200010)106:5<1036:ARPSOP>2.0.ZU;2-9
Fonte:
ISI
Lingua:
ENG
Soggetto:
AUTOGENOUS VEIN GRAFT; CLINICAL-EVALUATION; PERIPHERAL-NERVE; REGENERATION; REPAIR; GAP; RAT; COMPLICATIONS; COMPRESSION; DEFECTS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
45
Recensione:
Indirizzi per estratti:
Indirizzo: Weber, RA 2401 S 31st St, Temple, TX 76508 USA 2401 S 31st St Temple TX USA 76508 1st St, Temple, TX 76508 USA
Citazione:
R.A. Weber et al., "A randomized prospective study of polyglycolic acid conduits for digital nerve reconstruction in humans", PLAS R SURG, 106(5), 2000, pp. 1036-1045

Abstract

This article reports the first randomized prospective multicenter evaluation of a bioabsorbable conduit for nerve repair. The study enrolled 98 subjects with 136 nerve transections in the hand and prospectively randomized the repair to two groups: standard repair, either end-to-end or with a nerve graft, or repair using a polyglycolic acid conduit. Two-point discrimination was measured by a blinded observer at 3, 6, 9, and 12 months after repair. There were 56 nerves repaired in the control group and 46 nerves repairedwith a conduit available for follow up. Three patients had a partial conduit extrusion as a result of loss of the initially crushed skin flap. The overall results showed no significant difference between the mio groups as a whole. In the control group, excellent results were obtained in 43 percent of repairs, good results in 43 percent, and poor results in 14 percent. In those nerves repaired with a conduit, excellent results were obtained in 44 percent, good results in 30 percent, and poor results in 26 percent(p = 0.46). When the sensory recovery was examined with regard to length of nerve gap, however, nerves with gaps of 4 mm or less had better sensationwhen repaired with a conduit; the mean moving two-point discrimination was3.7 +/- 1.4 mm for polyglycolic acid tube repair and 6.1 +/- 3.3 mm for end-to-end repairs (p = 0.03). All injured nerves with deficits of 8 mm or greater were reconstructed with either a nerve graft or a conduit. This subgroup also demonstrated a significant difference in favor of the polyglycolicacid tube. The mean moving two-point discrimination for the conduit was 6.8 +/- 3.8 mm, with excellent results obtained in 7 of 17 nerves, whereas the mean moving two-point discrimination for the,graft repair was 12.9 +/- 2.4 mm, with excellent results obtained in none of the eight nerves (p < 0.001 and p = 0.06, respectively). This investigation demonstrates improved sensation when a conduit repair is used for nerve gaps of 4 mm or less, compared with end-to-end repair of digital nerves. Polyglycolic acid conduit repair also produces results superior to those of a nerve graft for larger nerve gaps and eliminates the donor-site morbidity associated with nerve-graft harvesting.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 15:28:38